A Prospective Study of Intraprostatic Inflammation, Focal Atrophy, and Progression to Lethal Prostate Cancer.
Journal
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
ISSN: 1538-7755
Titre abrégé: Cancer Epidemiol Biomarkers Prev
Pays: United States
ID NLM: 9200608
Informations de publication
Date de publication:
12 2019
12 2019
Historique:
received:
21
06
2019
revised:
15
08
2019
accepted:
11
09
2019
pubmed:
20
9
2019
medline:
12
9
2020
entrez:
20
9
2019
Statut:
ppublish
Résumé
Inflammation and focal atrophy are common features adjacent to prostate tumors. Limited evidence exists on whether these features have prognostic significance. In the Health Professionals Follow-Up Study and Physicians' Health Study, we studied 1,035 men diagnosed with prostate cancer. A genitourinary pathologist centrally reviewed tumor and normal areas of hematoxylin and eosin slides from prostate cancer specimens for the presence of acute and chronic inflammation, and four subtypes of focal atrophy. Cox proportional hazards models adjusted for potential confounders were used to estimate HRs and 95% confidence intervals (CI) for the association of these features with lethal prostate cancer, defined as development of metastatic disease or death during follow-up. During a median of 12 years of follow-up, 153 men developed lethal prostate cancer. A total of 84% of men had histologic evidence of chronic inflammation and 30% had acute inflammation. Both chronic and acute inflammation were inversely associated with lethal prostate cancer in age- and lifestyle-adjusted models. Chronic inflammation remained inversely associated with lethal prostate cancer after additionally adjusting for prognostic clinical features (HR = 0.45; 95% CI, 0.30-0.69 for mild and HR = 0.51; 95% CI, 0.33-0.80 for moderate to severe). None of the atrophic lesions were associated with lethal prostate cancer. Our data suggest that the presence of inflammation, particularly chronic inflammation, in prostate cancer tissue is associated with better prognosis among patients with prostate cancer. This is the largest prospective cohort study to examine the association between inflammation, focal atrophy, and lethal prostate cancer.
Sections du résumé
BACKGROUND
Inflammation and focal atrophy are common features adjacent to prostate tumors. Limited evidence exists on whether these features have prognostic significance.
METHODS
In the Health Professionals Follow-Up Study and Physicians' Health Study, we studied 1,035 men diagnosed with prostate cancer. A genitourinary pathologist centrally reviewed tumor and normal areas of hematoxylin and eosin slides from prostate cancer specimens for the presence of acute and chronic inflammation, and four subtypes of focal atrophy. Cox proportional hazards models adjusted for potential confounders were used to estimate HRs and 95% confidence intervals (CI) for the association of these features with lethal prostate cancer, defined as development of metastatic disease or death during follow-up.
RESULTS
During a median of 12 years of follow-up, 153 men developed lethal prostate cancer. A total of 84% of men had histologic evidence of chronic inflammation and 30% had acute inflammation. Both chronic and acute inflammation were inversely associated with lethal prostate cancer in age- and lifestyle-adjusted models. Chronic inflammation remained inversely associated with lethal prostate cancer after additionally adjusting for prognostic clinical features (HR = 0.45; 95% CI, 0.30-0.69 for mild and HR = 0.51; 95% CI, 0.33-0.80 for moderate to severe). None of the atrophic lesions were associated with lethal prostate cancer.
CONCLUSIONS
Our data suggest that the presence of inflammation, particularly chronic inflammation, in prostate cancer tissue is associated with better prognosis among patients with prostate cancer.
IMPACT
This is the largest prospective cohort study to examine the association between inflammation, focal atrophy, and lethal prostate cancer.
Identifiants
pubmed: 31533941
pii: 1055-9965.EPI-19-0713
doi: 10.1158/1055-9965.EPI-19-0713
pmc: PMC6941930
mid: NIHMS1540350
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
2047-2054Subventions
Organisme : NCI NIH HHS
ID : P30 CA006516
Pays : United States
Organisme : NCI NIH HHS
ID : P30 CA006973
Pays : United States
Organisme : NCI NIH HHS
ID : U01 CA113913
Pays : United States
Organisme : NCI NIH HHS
ID : U01 CA167552
Pays : United States
Informations de copyright
©2019 American Association for Cancer Research.
Références
Cancer Epidemiol Biomarkers Prev. 2012 Sep;21(9):1497-509
pubmed: 22736790
Int J Cancer. 2007 Oct 1;121(7):1571-8
pubmed: 17450530
Immunity. 2001 May;14(5):523-34
pubmed: 11371355
Histopathology. 2012 Jan;60(1):199-215
pubmed: 22212087
Cancer Causes Control. 2018 Jun;29(6):581-588
pubmed: 29663110
Adv Exp Med Biol. 2014;816:153-81
pubmed: 24818723
Am J Surg Pathol. 2006 Oct;30(10):1281-91
pubmed: 17001160
J Urol. 2015 Nov;194(5):1241-6
pubmed: 26165588
Urology. 1999 Sep;54(3):467-72
pubmed: 10475356
Int J Cancer. 2015 Aug 15;137(4):949-58
pubmed: 25648070
J Pathol Bacteriol. 1954 Oct;68(2):617-21
pubmed: 14354565
Nat Rev Cancer. 2012 Mar 22;12(4):252-64
pubmed: 22437870
Am J Pathol. 1999 Dec;155(6):1985-92
pubmed: 10595928
Prostate Cancer Prostatic Dis. 2018 Apr;21(1):106-112
pubmed: 29203895
BJU Int. 2013 Oct;112(6):735-41
pubmed: 23746332
Cancer. 2009 Aug 15;115(16):3670-9
pubmed: 19536890
Cancer Epidemiol Biomarkers Prev. 2017 Oct;26(10):1549-1557
pubmed: 28754796
Prostate. 2017 Mar;77(4):412-424
pubmed: 27868214
Cancer Epidemiol Biomarkers Prev. 2017 May;26(5):719-726
pubmed: 28062398
Cancer Epidemiol Biomarkers Prev. 2011 Oct;20(10):2280-7
pubmed: 21953116
Prostate. 2009 Sep 15;69(13):1378-86
pubmed: 19507201
J Natl Cancer Inst. 2015 Nov 27;108(2):
pubmed: 26615022
Cancer Prev Res (Phila). 2012 Oct;5(10):1223-8
pubmed: 22961777
N Engl J Med. 1996 May 2;334(18):1145-9
pubmed: 8602179
Clin Cancer Res. 2014 Sep 15;20(18):4904-11
pubmed: 24687926
Am J Clin Pathol. 1968 Mar;49(3):347-57
pubmed: 5645095
Cancer. 2014 Jan 15;120(2):190-6
pubmed: 24323568
Eur Urol. 2011 Jul;60(1):106-17
pubmed: 21497433
Int Braz J Urol. 2007 May-Jun;33(3):355-60; discussion 361-3
pubmed: 17626652
World J Urol. 2013 Dec;31(6):1497-503
pubmed: 23546767
Urology. 2000 Nov 1;56(5):828-32
pubmed: 11068311
Urology. 2005 Apr;65(4):745-9
pubmed: 15833520