We performed a comprehensive literature review and meta-analysis evaluating the association of inflammation on prostate needle biopsies (PNB) and prostate cancer (PCa) risk.
We searched EMBASE, PubMed, and Web of Science from January 1, 1990 to October 1, 2016 for abstracts containing PCa, inflammation, and biopsy keywords. Inclusion criteria were original research, adult human subjects, cohort or case-control study design, histologic inflammation on PNB, and PCa demonstrated on histology. Two independent teams reviewed abstracts and extracted data from the selected manuscripts. Combined odds ratio (OR) and 95% confidence intervals (CI) for any, acute and chronic inflammation were calculated using random effects method.
Of the 1030 abstracts retrieved, 46 underwent full text review and 25 studies were included in the final analysis, comprising 20,585 subjects and 6,641 PCa cases. There was significant heterogeneity among studies (I2 = 84.4%, P<0.001). The presence of any inflammation was significantly associated with a lower PCa risk (OR = 0.455, 95% CI = 0.337 - 0.573, 25 studies). There was no evidence of publication bias (P>0.05). When sub-analyzed by type of inflammation, the presence of acute (OR = 0.681, 95% CI = 0.450 - 0.913, 4 studies) and chronic inflammation (OR = 0.499, 95% CI = 0.334 - 0.665, 15 studies) were each associated with lower PCa risk.
In a meta-analysis of 25 studies, inflammation on PNB was associated with lower PCa risk. Clinically, the presence of inflammation on PNB may lower the risk of subsequent PCa diagnosis.
The Journal of urology. 2017 Dec 12 [Epub ahead of print]
Shaleen R Vasavada, Ryan W Dobbs, André A Kajdacsy-Balla, Michael R Abern, Daniel M Moreira
Department of Urology, University of Illinois at Chicago., Department of Pathology, University of Illinois at Chicago., Department of Urology, University of Illinois at Chicago. Electronic address: .