Subjects in this paper were part of the Reduction by Dutasteride of PCa Events (REDUCE) study, a clinical trial enrolling men who had undergone a single negative prostate biopsy within six months of enrollment and subjecting them to a repeat biopsy every two years. A retrospective analysis of 6065 men in the study was performed, assessing any association of acute prostate inflammation (API) or chronic prostate inflammation (CPI) at baseline biopsy with the incidence of prostate cancer on the two-year biopsy. API was defined as cores containing neutrophilic infiltrate while CPI was defined as cores containing lymphocytes, plasma cells and macrophages. Men were categorised into the percentage of cores containing API or CPI. Younger age, lower prostate specific antigen (PSA) and lower prostate volume were associated with more extensive API. Older age, lower PSA and higher prostate volume were associated with more extensive CPI. Both forms of inflammation were associated with a lower risk of prostate cancer on both uni- and multi-variate analysis. The authors suggest a possible temporal connection between inflammation and lower risk of prostate cancer although it is difficult to conclude this in a retrospective study. It does, however, highlight the importance of reporting inflammation where present on a biopsy report as it may aid clinicians in further management.
Results from the REDUCE study
Reviewed by Pravisha Ravindra
Greater extent of prostate inflammation in negative biopsies is associated with lower risk of prostate cancer on repeat biopsy: results from the REDUCE study.
