Histological Prostatitis Research Articles

Evidence of Programmed Death-Ligand 1 Expression in a Highly Inflammatory Prostate: A Literature Review and Our Experience.

Chronic inflammation (CI), a common finding in the human prostate, is associated with the most frequent socially important prostate diseases: prostatitis, benign prostatic hyperplasia, and prostate adenocarcinoma. Programmed cell death protein 1 (PD-1) and its ligand (PD-L1) expression are induced on the surface of immune and epithelial cells of healthy and tumor tissues in response to various cytokines. Here, we provide a comprehensive review of the PD-1/PD-L1 pathway in the non- and peri-tumoral inflammatory prostate, focusing on the structure and expression of PD-L1 and the diverse biological functions of PD-L1 signaling in health, high-grade CI (National Institutes of Health, category IV prostatitis or histologic prostatitis), and immune-related diseases, including autoimmunity, tumor microenvironmental immunity, and immune privilege. This review explores the possible pathophysiological interpretations of clearly visible, selective, and strong PD-L1 expression in the immuno-inflammatory-induced and related, histologically distinct sites of this expression: the ductal lymphoepitheliallesions and prostatic granulomas.

The clinical research of modified chailing paste treated small volume prostatic hyperplasia with chronic prostatitis patients after TURP about LUTS and bladder neck contracture

Objective: To explore the clinical effect and safety of modified Chailing paste on improving postoperative lower urinary tract symptoms (LUTS) and bladder neck contracture in pa-tients with small-volume prostatic hyperplasia (SBPH) complicated with chronic prostatitis after transurethral resection of the prostate (TURP). Methods: A total of 145 patients with SBPH were enrolled in a randomized double-blind placebo-controlled study and randomly divided into three groups. Group A (49 patients) underwent simple TURP, Group B (48 patients) underwent TURP combined with postoperative Tamsulosin, and Group C (48 pa-tients) underwent TURP combined with modified Chailing paste. Tissue specimens from all patients were sent for pathological examination. Data were analyzed using SPSS22.0 statistical software. Results: The study followed up 141 patients. The detection rate of his-tological prostatitis (HP) was 92.91%. Significant improvements in residual urine volume (PVR), International Prostate Symptom Score (IPSS), quality of life (QOL) score, and max-imum urine flow rate (Qmax) were observed in all groups before and 3 months after surgery (P < 0.01). Group C showed statistically significant improvement compared to Groups A and B (P < 0.05). The incidence of bladder neck contracture 12 months post-operation was significantly lower in Group C compared to Groups A and B (P < 0.05). Conclusion: Modified Chailing paste significantly improves postoperative LUTS symptoms and qual-ity of life and reduces the incidence of bladder neck contracture in patients with SBPH complicated with chronic prostatitis after TURP.

Analysis of Postoperative Urinary Incontinence and Influencing Factors of Transurethral Holmium Laser Enucleation of the Prostate

Introduction: Aims of the study were to investigate the related factors of urinary incontinence after transurethral holmium laser enucleation of the prostate (HoLEP) and to provide guidance for clinical urinary control of HoLEP. Methods: The clinical data of 548 patients who underwent HoLEP were retrospectively analyzed. The patients were followed up for the occurrence of urinary incontinence in the short term (2 weeks), medium term (3 months), and long term (6 months) after HoLEP. Results: Among the 548 benign prostatic hyperplasia patients, 79 cases (14.42%) had urinary incontinence at 2 weeks, 19 cases (3.47%) at 3 months, and 2 cases (0.36%) at 6 months after surgery. Logistic regression analysis showed that age, prostate volume, diabetes mellitus, operation time, prostate tissue weight, and histological prostatitis were risk factors for recent urinary incontinence (p < 0.05). Age, diabetes, and operation time were risk factors for mid-term urinary incontinence (p < 0.05). The incidence of long-term urinary incontinence was low and no risk factor analysis was performed. Conclusions: For good urinary control after HoLEP, in addition to surgery-related factors such as surgical skills, proficiency, and precise anatomy, patients’ risk factors should also be paid attention to in order to improve postoperative urinary control more effectively and reduce the incidence of urinary incontinence.

Correlation of Total Serum Prostate Specific Antigen and Prostate Specific Antigen Density with subclinical inflammation in Benign Prostatic Hyperplasia

Background Serum PSA is an important tumor marker for diagnosis of prostate cancer. However, it can rise in some other benign conditions like benign prostatic hyperplasia (BPH), prostatitis, prostatic infarct, instrumentation, prostate manipulations like examination, transurethral resection and urinary tract infection (UTI). The aim of this study was to find correlation of total serum PSA and PSAD with extent and aggressiveness of subclinical inflammation in BPH.MethodsThis cross-sectional study was conducted on 25 cases of transurethral resection of prostate and open prostatectomy specimens diagnosed with BPH received in time period of July 2022 to June 2023. Cases with clinical signs and symptoms of prostatitis, positive urine culture, diagnosed as prostate cancer, cases with history of previous surgery of prostate and history of instrumentation of urinary tract were excluded. Total serum PSA and prostate weight were measured. PSAD was calculated. Histological inflammation was graded with respect to extent and aggressiveness. PSA and PSAD were correlated with extent and aggressiveness of inflammation.ResultsThere was no statistically significant correlation between inflammation extent score and total serum PSA (p = 0.318). Also, there was no correlation between inflammation extent score and PSAD (p = 0.308). However, there was significant correlation between inflammation aggressiveness score and total serum PSA (p = 0.011). Similarly, there was also correlation between inflammation aggressiveness score and PSAD (p = 0.010).Conclusions Repeat unnecessary biopsies may be avoided in cases with high total serum PSA in presence of glandular epithelial disruption in histological prostatitis.

The histological prevalence of prostatitis at Potchefstroom Hospital: a cross-sectional study.

prostatitis is defined as a clinical condition caused by acute or chronic infectious diseases, chronic pelvic pain syndrome, or asymptomatic inflammation of the prostate gland. We conducted a study to determine the prevalence of histological prostatitis in patients with prostatic diseases at Potchefstroom Hospital. we conducted a cross-sectional study based on the review of histology report from 1st January 2015 to 31st December 2019 coupled to clinical information of patients. A total of 362 cases with complete histopathology report were included in the study. Chi-square and Fisher exact test were used to test statistical significance with a p-value of 0.05 deemed to be significant. over a total number of 362 patients, the mean age was 69.82±7.9 years. The overall prevalence of prostatitis on histology was 158 (43.65%). Chronic prostatitis was predominant and commonly associated with BPH or PCa in 142 cases (39.23%) on histopathology report, while acute prostatitis was found in 16 patients (4.42%). We further found prostate cancer in 178 patients (49.17%), BPH in 163 (45.03%). The study shows that 41 cases (23.3%) of prostate cancer were associated with prostatitis, and 96 cases (58.9%) of BPH were also associated with prostatitis on histology. The difference was statistically significant p < 0.001. The study revealed that in BPH with prostatitis the median PSA was 15 ng/ml (IQR 9-24), while in BPH without prostatitis the median PSA was 11ng/ml (IQR 7-16). (p < 0.017). This means that prostatitis increases PSA in patients with BPH. However, the presence of prostatitis did not significantly influence the PSA value in patients with prostate cancer. this study showed that close to half of the histology examined had signs of prostatitis. Chronic prostatitis was more frequent on histology done in our sample. BPH was strongly associated with prostatitis. Prostatitis contributed to a higher PSA values in patients with BPH and did not influence the PSA value in PCa.

Strong PD-L1 expression in granulomatous prostatitis.

The expression of programmed cell death ligand protein (PD-L1) is weakly investigated in non-tumoral and inflammatory prostatic pathology. The diagnosis of granulomatous prostatitis (GP) rests on the recognition of localized or diffuse epithelioid granulomatous inflammation in prostatic tissue which is frequently difficult by conventional histological observation alone. PD-L1 expression in GP is not well studied so far. We studied PD-L1 expression in 17 GP cases (9 nonspecific GP, 5 Bacillus Calmette-Guérin induced prostatitis, 1 prostatic tuberculosis, and 3 cases of postsurgical prostatic granulomas). The control group included 10 radical prostatectomies of patients with high Gleason score prostate adenocarcinoma (PCa) and National Institutes of Health-category IV prostatitis (high-grade histologic prostatitis; HG-HP). All of the GP cases showed easily visible strong membranous PD-L1 expression (high levels of combined positive score) in localized and diffuse epithelioid granulomatous prostatic inflammation. None of the control cases showed the presence of significant PD-L1 expression in inflammatory infiltrates in HG-HP, tumor parenchyma, and stroma in PCa. The study presents the first attempt to examine PD-L1 expression in GP. Granulomatous inflammation in GP is easily identified when stained with PD-L1.

Does histological prostatic inflammation during transurethral resection of the prostate for bladder outlet obstruction affect post‐operative urinary outcomes?

Benign prostate hyperplasia (BPH) is a common cause for bladder outlet obstruction (BOO) and lower urinary tract symptoms (LUTS) in men. The pathophysiology of BPH is multifactorial and inflammation has been linked with progression of BPH and LUTS. The association between histological prostatitis found at transurethral resection of the prostate (TURP) and adverse post-operative urinary outcomes is not clearly defined. Our aim was to evaluate the association between histological prostatitis and adverse post-operative urinary outcomes following TURP procedure. Patients who had undergone TURP for BPH at a single institution between 2014 and 2018 were included. The study population was divided into three cohorts: those with no histological inflammation, those with any form of inflammation and those specifically with prostatic stromal inflammation. Functional outcomes were assessed by defining a series of measurable post-operative "LUTS events" and comparing these to time-to-event profile using a Kaplan-Meier estimator. A total 198 patients were included (no inflammation n=101; any inflammation n=97, prostatic stromal inflammation n=81). All three groups were comparable in terms of baseline characteristics. The any inflammation group had significantly more adverse post-operative outcomes after TURP compared to the no inflammation group, P=0.0065. The stromal inflammation group had more LUTS events after surgery compared to the no inflammation groups in the first year of follow-up n=0.011; over a 5-year follow-up period the results were not statistically significant, P=0.244. Histological prostatitis is associated with worse urinary outcomes after TURP compared to no inflammation. These results are useful in improving prognostic discussions with patients after TURP.

MP33-17 TRANSPERINEAL FUSION BIOPSIES WITH SOFTWARE REGISTRATION: CANCER DETECTION BY PIRADS V2

You have accessJournal of UrologyCME1 May 2022MP33-17 TRANSPERINEAL FUSION BIOPSIES WITH SOFTWARE REGISTRATION: CANCER DETECTION BY PIRADS V2 Eusebio Luna, Gloria Egui-Benatuil, Alberto Lopez-Prieto, Edward Gheiler, Kaufman Ariel, Farshad Shafizadeh, Luis Avila, Barrios Dailianys, Juan Martinez-Salamanca, and Fernando Bianco Eusebio LunaEusebio Luna More articles by this author , Gloria Egui-BenatuilGloria Egui-Benatuil More articles by this author , Alberto Lopez-PrietoAlberto Lopez-Prieto More articles by this author , Edward GheilerEdward Gheiler More articles by this author , Kaufman ArielKaufman Ariel More articles by this author , Farshad ShafizadehFarshad Shafizadeh More articles by this author , Luis AvilaLuis Avila More articles by this author , Barrios DailianysBarrios Dailianys More articles by this author , Juan Martinez-SalamancaJuan Martinez-Salamanca More articles by this author , and Fernando BiancoFernando Bianco More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002587.17AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Recently, the European Urological Association guidelines on prostate biopsies made Transperineal Biopsies (TPBx) their standard of care and advised against transrectal biopsies due to harms such as UTI and urosepsis. We stopped performing TRBx in 2017. Herein we present our experience with TPBx, using fusion registration (MR/US) with a medical device. We aimed to determine the accuracy of piRADS V2 system in this setting. METHODS: For this study, we evaluated Fusion TPBx conducted from October 2017 and May 2021 conducted across 4 centers. Antibiotic prophylaxis was dependent on the surgeon. Indications for TPBx: elevated PSA, abnormal DRE, Prostate Cancer history. Patients had a multiparametric MRI within 3 months of their TPBx. The MRI was classified using piRADS system and lesions were contoured. Post biopsies follow up consisted of a results visitation and a 30-day phone call that inquired for averse events (AE). The path from the procedure and 30-day outcomes was prospectively collected into the FocalyxApp (IOS & Android). Correlations between TPBx results, piRADS, presence of prostatitis and prophylactic antibiotics were performed using chi-squares and Bayesan statistics. RESULTS: 1,317 Fusion TPBx were performed, 1,189 (90%), were conducted under local anesthesia in the office. Prophylactic antibiotics were NOT used in 579 (44%). No episodes of UTI or sepsis were detected. Median Age, BMI, PSA, MR volume, total cores, target cores, pain reported and Fusion TPBx time was 68.6 years, 27.6 kg/m2, 5.7 ng/ml, 53cc, 16, 7, 3/10 and 19min, respectively. Cancer was found in 617 (47%). The piRADS V2 detection rate for scores 2,3,4 and 5 were 11/35 (15%), 201/661(30%), 241/382(63%) and 162/199 (81%), respectively. Overall, 572 patients had histological evidence of prostatitis, 276/579 (44%) of the NO prophylaxis group and 316/738 (43%) of the prophylaxis group, p=0.6. There was no statistical association between histological prostatitis and piRADS, p=0.4. At 30 days, 48 patients experienced an AE, none experience any bacterial proven infection. The most common being urinary retention which occurred in 31 patients and correlated with MR Prostate Volume (Spearman, p=0.001). There were no correlations between AE and antibiotic use or piRADS in MRI. CONCLUSIONS: Our study performed using software fusion registration illustrates the value of the piRADS system. Furthermore, it questions the necessity of antibiotic prophylaxis for TPBx and shows the high prevalence of histological prostatitis neither correlated to piRADS or prophylaxis. Source of Funding: Urological Research Network Foundation © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e576 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Eusebio Luna More articles by this author Gloria Egui-Benatuil More articles by this author Alberto Lopez-Prieto More articles by this author Edward Gheiler More articles by this author Kaufman Ariel More articles by this author Farshad Shafizadeh More articles by this author Luis Avila More articles by this author Barrios Dailianys More articles by this author Juan Martinez-Salamanca More articles by this author Fernando Bianco More articles by this author Expand All Advertisement PDF DownloadLoading ...

The association between histological prostatitis and benign prostatic hyperplasia: a single-center retrospective study

Objective To investigate the relationship between histological prostatitis (HP) and clinical parameters related to benign prostatic hyperplasia (BPH) in male. Method The clinical data of 196 BPH patients who underwent transurethral resection of the prostate were collected. According to the results of hematoxylin-eosin (H&E) staining of prostate tissue, patients were divided into two groups: BPH with HP group and BPH without HP group. Differences in acute urinary retention (AUR), prostate volume (PV), serum sex hormones, lower urinary tract symptoms (LUTS) related parameters, and systemic inflammation indicators were compared between the two groups. SPSS software v.25 was used for statistical analysis. Results Compared with the BPH without HP group, the BPH with HP group had greater AUR rate, PV, total IPSS, and IPSS-storage in BPH with HP group (p < 0.05). However, there were no significant differences in IPSS-voiding, post-void residual volume, maximum urinary flow rate, serum sex hormones, and systemic inflammation indicators between the two groups (p > 0.05). Conclusions This study suggests that patients with HP have larger PV, more severe LUTS, and a higher risk of AUR. HP is closely related to BPH and may be a key factor in the occurrence and clinical progress of BPH.

Inflammation induced by lipopolysaccharide advanced androgen receptor expression and epithelial-mesenchymal transition progress in prostatitis and prostate cancer.

BackgroundTo explore the mechanism of prostatic inflammation on prostate cancer (PCa) by comparing the changes of prostate epithelial cells and PCa cells in an inflammatory environment.MethodsFirst, immunohistochemistry (IHC) was used to compare the level of expression of TNF-α, IL-1β, IL-6, and TGF-β between benign prostatic hyperplasia (BPH), prostatitis, and PCa. Then primary prostate epithelial cells were sampled from patients who were suspected of PCa and had histological prostatitis (HP) confirmed by pathological biopsy. Lipopolysaccharide (LPS) or BAY11-7082 were used to investigate the change of androgen receptor (AR) and AR-mediated transcription, epithelial-mesenchymal transition (EMT) in primary prostate epithelial cells, and lymph node carcinoma of the prostate (LNCap) cells.ResultsTNF-α, IL-1β, IL-6, and TGF-β were significantly increased in HP and PCa compared with those in BPH patients. The proliferation of primary prostate epithelial cells and LNCap cells got the inflection point at LPS 10 µg/mL. In an inflammatory environment with 10 µg/mL LPS, both primary prostate epithelial cell and LNCap cell viability increased, and AR, AR-mediated transcription, and EMT processes were significantly increased. Inhibitors of NF-κB with 10 nM BAY11-7082 decreased AR, AR-mediated transcription, and EMT processes.ConclusionsNF-κB regulates AR expression and EMT in prostatitis and PCa, and NF-κB inhibitors may have potential therapeutic value.

Diagnosis of chronic prostatitis by noninvasive methods in elderly patients with benign prostatic hyperplasia in China.

Chronic prostatitis is hard to be identified in BPH patients in clinical works. This study aimed to diagnose chronic prostatitis in BPH patients by noninvasive methods. BPH patients who received transurethral resection of prostate from January 2014 to July 2015 were enrolled in current study. Patients were received examinations of PSA, sex hormones, inflammatory cytokines, metabolic panel and transrectal ultrasonography. According to histological results, patients were divided into two group of BPH with/without prostatitis. Logistic regression was used to find risk factors of chronic prostatitis. As a result, 181 men with an average age of 72.15±8.41years were enrolled in this study, including 116 patients with prostatitis and 65 patients without prostatitis. The storage sub-score, PSA and IL-2R were significantly higher in patients with prostatitis than those without prostatitis. Based on logistic regression analysis, the above three parameters were also the risk factors of BPH with prostatitis. The diagnostic model was calculated as: 0.317×storage sub-score+0.092×PSA+0.003×IL-2R-4.296. The AUC was 0.725. Histological prostatitis in BPH patients can be diagnosed by the combination of serum IL-2R, PSA and storage sub-score. Identification of chronic prostatitis in BPH patients could more efficiently alleviate urinary symptoms and reduce the risk of disease progression.

Experimental autoimmune prostatitis: different antigens induction and antigen-specific therapy.

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) has uncertain etiology and lacks effective treatment. Autoimmunity is an important pathogeny, and experimental autoimmune prostatitis (EAP) models have long been used for studying CP/CPPS. This review presents the detailed current knowledge of EAP models based on evaluation criteria aspects to provide a tool for model selection in pathogenesis studies and therapeutic drug screening. We extensively searched the published literature on CP/CPPS and different antigen-induced EAP models focusing on the histopathology, clinical-related phenotypes, and biochemical indicators. We also cover the changes in the prostate function and other organs in EAP. Finally, we try to get some insights about antigen-based therapeutic approaches for CP/CPPS. Several inciting autoantigens were reported in EAP, including male accessory gland extracts, prostate extracts (PE), prostatic steroid-binding protein, prostatic spermine-binding protein (p25), prostatic acid phosphatase, seminal vesicle secretory protein 2, and T2 peptide. All of these models mimicked histological prostatitis, however only p25- and T2-induced models developed both pelvic pain and voiding behaviors. PE immunization is the most widely used method. Diminished fertility and mental health disorders can be found in PE model. Oral and intravenous T2 peptide have been studied for antigen-specific therapy and achieved preliminary progress in EAP models. PE-induced model is the most commonly used, while T2- or p25-model could serve as a promising CP/CPPS model. Antigen-specific therapy in CP/CPPS deserves further study.

Histopathology of nonspecific granulomatous prostatitis with special reference to eosinophilic epithelial metaplasia: Pathophysiologic, diagnostic and differential diagnostic correlations.

Recently, we publish two case reports about association of nonspecific granulomatous prostatitis (NSGP) and eosinophilic metaplasia (EM) in benign prostatic epithelium. There is no investigation of large series of this association in medical literature. Aim of the current study is to investigate the frequency of association of NSGP and prostatic EM in a large series of cases and their relationship with the basic prostate pathology: benign prostatic hyperplasia (BPH), National Institutes of Health-category IV prostatitis (so-called histologic prostatitis (HP)), and prostatic adenocarcinoma (PCa). A retrospective record review for NSGP was performed on a total of 2366 prostatic specimens of all types of material. All cases of NSGP were reviewed for the presence of EM, BPH, and HP. NSGP with EM-cases and control cases with high grade PCa with endocrine differentiation (so-called Paneth cell-like changes) were evaluated immunohistochemically. NSGP was found in nine cases (0.38%). EM was detected in benign perigranulomatous secretory epithelial cells in 100% of cases with NSGP and were closely associated with BPH and HP. Immunohistochemically, in 55.5% of cases with EM, there was weak focal apical false-positive staining for p504s. EM is a very common lesion in NSGP and reflects histologically a nonspecific cellular response, connected with repeated inflammation, in close relation with BPH and HP. We speculate that EM might serve as a morphological precursor of the immunologic phase of NSGP. This constant morphological finding could facilitate the histopathological differential diagnosis of NSGP with other types of granulomatous prostatitis and high grade PCa with or without endocrine differentiation.

Analysis of Prostate-Specific Antigen-Related Indexes, Neutrophil-to-Lymphocyte Ratio in Patients with Concurrent Benign Prostatic Hyperplasia and Histologic Prostatitis.

This study was performed to explore the total prostate-specific antigen (tPSA) concentration, free PSA (fPSA) concentration, free-to-total PSA ratio (% fPSA), tPSA density (tPSAD), and neutrophil-to-lymphocyte ratio (NLR) in blood in patients with concurrent benign prostatic hyperplasia (BPH) and histologic prostatitis, and to provide new ideas for the diagnosis of prostatitis. Patients who underwent transurethral bipolar plasmakinetic prostatectomy from June 2017 to June 2018 were retrospectively divided into two groups according to the degree of pathological inflammation of the resected prostate tissue: group A (BPH with histologic acute and chronic inflammation), group B (BPH with histologic chronic inflammation). The preoperative PSA-related indexes and NLR in blood were respectively compared between two groups. Groups A and B comprised 59 and 41 cases, respectively. The values of tPSA, tPSAD, and NLR were all significantly higher in group A than B, and the value of % fPSA was significantly lower in group A than B (p < 0.05). There was no significant difference for the value of fPSA between the two groups (p > 0.05). Histologic acute prostatitis can cause changes of PSA-related indexes and NLR in blood, which has important clinical significance in diagnosis of prostatitis.

Eosinophilic metaplasia in transurethral resection of the prostate

To investigate prostatic eosinophilic metaplasia (EM) in a large series of cases and their relationship with the basic prostate pathology in TURP-material: benign prostatic hyperplasia (BPH), National Institutes of Health category IV prostatitis (also called histologic prostatitis or HP), and prostatic adenocarcinoma (PCa). The relation between EM and basic prostate pathology: BPH, PCa, and HP. Around 61 consecutive TURP-specimens were reviewed for the presence of EM. The tissue sections were stained routinely with hematoxylin-eosin (HE), hematoxylin-phloxine-saffron (HPS), and periodic acid-Schiff's procedure. Simultaneously BPH, HP, and PCa were evaluated. We found EM in 55.7% of TURP-specimens. EM is located more often in the ductal epithelium (58.8%) and is usually focal (73.5%) and in small groups (88.2%) of secretory luminal cells. They are associated with BPH and with a variable degree of HP in all cases. However, there is no association with PCa. Eosinophilic cytoplasmic granules in EM are better visualized with HPS. Zones induced by tissue electrocoagulation which mimic EM, are seen in the periphery of TURP-fragments. EM in prostate is presented by the presence of eosinophilic cytoplasmic granules in benign secretory epithelium. The study presents the first attempt to investigate EM in a large series of patients. Our results enrich the available information about the histoepidemiology of prostatic EM. Moreover, EM is more common in a focal lesion, found in small groups of ductal secretory epithelial cells while EM in TURP-specimens is associated with BPH and HP in all the cases.

Potential effect of anti-inflammatory drug use on PSA kinetics and subsequent prostate cancer diagnosis: Risk stratification in black and white men with benign prostate biopsy.

Rising prostate-specific antigen (PSA) levels are associated with both increased risk of prostate cancer and prostatic inflammation. The confounding effects of inflammation on the utility of PSA kinetics to predict prostate cancer may be partially mitigated by anti-inflammatory drug use. We investigated the influence of anti-inflammatory drug use on the association of PSA kinetics with prostate cancer risk. We studied 488 prostate cancer case-control pairs (290 white, 198 African American (AA)) nested in a retrospective cohort of men with a benign prostate biopsy. A series of multivariable models estimated prostate cancer risk associated with PSA velocity (PSAV) at different levels of anti-inflammatory drug use while adjusting for the presence of both clinical and histologic prostatitis. In men with one, two, or three or more courses of anti-inflammatory drug use, for each ng/mL/year increase in PSAV, prostate cancer risk increased 1.21-fold, 1.83-fold, and 1.97-fold, respectively ( P < 0.0001). In controls with histologic prostatitis, anti-inflammatory drug use was associated with a significantly lower PSAV ( P < 0.0001). This association was not observed in men with histologic prostatitis who were subsequently diagnosed with prostate cancer. A positive interaction between anti-inflammatory drug use and PSAV-associated prostate cancer risk was only observed in AA men, as well as a strong positive association between any anti-inflammatory drug use and clinical prostatitis ( P = 0.004). In men with benign prostate biopsy, accounting for the presence of histologic prostatitis and anti-inflammatory drug use, particularly in AA men, may help distinguish between men with rising PSA because of prostatitis vs undiagnosed cancer.

Differential research of inflammatory and related mediators in BPH, histological prostatitis and PCa.

Prostate cancer (PCa) is one of the most common male malignancies in the world. It was aimed to investigate differential expression of inflammatory and related factors in benign prostatic hyperplasia (BPH), prostate cancer (PCa), histological prostatitis (HP) and explore the role of Inducible nitric oxide synthase (iNOS), (VEGF) Vascular endothelial growth factor, androgen receptor (AR) and IL-2, IL-8 and TNF-α in the occurrence and development of prostate cancer. RT-PCR was used to detect the mRNA expression level of iNOS, VEGF, AR and IL-2, IL-8 and TNF-α in BPH, PCa and BPH+HP. Western blotting and immunohistochemical staining were used to detect the protein levels of various proteins in three diseases. The results showed the mRNA and protein levels of iNOS, VEGF and IL-2, IL-8 and TNF-α were significantly increased in PCa and BPH+HP groups compared with BPH group (p<.05), while the AR was significantly lower than those in PCa and BPH+HP groups (p<.05). There was no significant difference in the mRNA and protein levels of iNOS, VEGF, AR and IL-2, IL-8 and TNF-α between PCa and BPH+HP groups (p>.05). iNOS, VEGF, AR and IL-2, IL-8 and TNF-α are involved in the malignant transformation of prostate tissue and play an important role in the development and progression of Prostate cancer (PCa).

Relation between histological prostatitis and lower urinary tract symptoms and erectile function.

BackgroundChronic prostatitis (CP) significantly worsens a patient's quality of life (QOL), but its etiology is heterogeneous. Although the inflammatory process must be associated with CP symptoms, not all patients with benign prostatic hyperplasia and histological prostatitis complain of CP symptoms. The relation between the severity of histological inflammation and lower urinary tract symptoms (LUTS) and erectile function is not fully understood.MethodsThis study comprised 26 men with suspected prostate cancer but with no malignant lesion by pathological examination of prostate biopsy specimens. LUTS were assessed by several questionnaires including the International Prostate Symptom Score (IPSS), QOL index, Overactive Bladder Symptom Score (OABSS), and the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI), and erectile function was assessed by the Sexual Health Inventory for Men. Prostate volume (PV) measured by transabdominal ultrasound, maximum flow rate by uroflowmetry, and serum concentration of prostate-specific antigen were also evaluated. All data collections were performed before prostate biopsy. Histological prostatitis was assessed by immunohistochemical staining with anti-CD45 antibody as the Quick score. The relation between the Quick score and several factors was assessed by Pearson correlation coefficient and a multivariate linear regression model after adjustment for PV.ResultsThe Pearson correlation coefficient showed a correlation between the Quick score and several factors including PV, IPSS, QOL index, OABSS, and NIH-CPSI. A multivariate linear regression model after adjustment for PV showed only the NIH-CPSI to be associated with the Quick score. The relation between the Quick score and each domain score of the NIH-CPSI showed only the subscore of urinary symptoms to be an associated factor.ConclusionWe found a correlation only between histological prostatitis and LUTS, but not erectile dysfunction. Especially, the subscore of urinary symptoms (residual feeling and urinary frequency) was associated with histological prostatitis.

The histologic characteristics of small-size prostatic hyperplasia and the effect on low urinary tract symptoms

Objective To investigate the histologic characteristics of small-size prostatic hyperplasia(SBPH) and the effect on low urinary tract symptoms (LUTS). Methods 154 patients with SBPH who received transurethral resection of prostate(TURP) were enrolled, preoperative examinations included the obtainment of International Prostate Symptom Score(IPSS), evaluation of the quality of life(QOL), cases of urinary retention, ultrasonography, urodynamic examination, and cystoscopy, postoperative pathology specimen analysis was conducted.The histologic characteristics of small-size prostatic hyperplasia(the histology prostatis and the grade of inflammation) and the effect on LUTS were analyzed. Results A total of 141 cases (91.56%) were diagnosed as SBPH with histological prostatitis, 13 cases(8.44%) in grade 0, 18 cases(11.69%) in grade 1, 76 cases(49.35%) in grade 2 and 47 cases(30.52%) in grade 3.There were statistically significant differences among ages, IPSS, QOL, Qmax, cases of urinary retention between the pure SBPH group and SBPH with HP group(t/χ2=2.610, 6.607, 4.925, 2.673, 4.421, all P 0.05). Conclusion The main pathologic type is stroma hyperplasia(fibrous and smooth muscle) of SBPH, SBPH is mostly complicated with histological prostatitis, which are mostly moderate and severe.The severity of LUTS is positively correlated with the grade of inflammation. Key words: Hyperplasia of prostatic; Histologic; Low urinary tract symptoms

Clinical study of bladder gasification and stasis dispersion in BPH patients with histological prostatitis after TUEP about IPSS/Qol score

Objective To evaluate the clinical efficacy of bladder gasification and stasis dispersion in BPH patients with histological prostatitis after TUEP about IPSS/Qol score. Methods 126 BPH patients with histological prostatitis after TURP were divided into group A, B and C of equal number, and received oral placebo, tamsulosin, and herbal decoction a week after operation, respectively, for a course of 4 weeks.IPSS and Qol score were evaluated. Results After 5 weeks, 121 cases finished the follow-up, the unfinished were 2 cases in group A, 2 cases in group B and 1 cases in group C. The differences of the IPSS total scores, irritative subscore, obstructive subscore, quality of life score in group C(7.16±3.37)points, (4.22±2.70)points, (2.94±2.06)points, (1.47±1.44)points were statistically significant than those in group A[(13.77±4.50)points, (7.48±3.50)points, (6.29±2.63)points, (2.83±1.72)points] and group B[(12.77±5.24)points, (8.05±3.88)points, (4.72±3.24)points, (3.07±1.67)points](t=2.692, 3.544, 3.296, 2.698 and t=2.326, 3.532, 2.418, 2.414; all P<0.05). There was only obstructive subscore in group B better than that in group A(t=2.572, P<0.05). Conclusion Bladder gasification and stasis dispersion is effective for the treatment of BPH patients with histological prostatitis after TUEP about IPSS and Qol score.The clinical effect is indeed and satisfactory. Key words: Prostatic hyperplasia; Vaporization by stasis soup; Prostatitis; Transurethral resection of prostate