Chronic Inflammation on Prostate Needle Biopsy as a Significant Predictor of the Lower Incidence Risk of Prostate Cancer

Chronic Inflammation on Prostate Needle Biopsy as a Significant Predictor of the Lower Incidence Risk of Prostate Cancer | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Chronic Inflammation on Prostate Needle Biopsy as a Significant Predictor of the Lower Incidence Risk of Prostate Cancer jiatong zhou, guangyu sun, ranlu liu This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-258933/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Purpose: At present, there is no clear relationship between prostatitis and prostate cancer(PCa). Therefore, in order to further understand the inflammation of prostate tissue and the occurrence of PCa, we conducted this study. Method: A total of 686 patients were enrolled in the study. All patients underwent prostate biopsy in our hospital. A retrospective analysis of the biopsy results was performed to assess the assocition between chronic inflammation and the risk of PCa. Result: Of the 686 patients, 354 were diagnosed with PCa, and 332 were benign. A total of 403 patients had prostate inflammation. PCa patients had lower prostate volume and transition zone volume than benign group(p＜0.001). Compared with benign group, PCa patients had lower PSA and PSA density (PSAD)(p＜0.001). We also found that the probability of inflammation in PCa patients is lower than that in the benign group (p＜0.001). In multivariate analyses, chronic inflammation was negatively correlated with the incidence of PCa（OR=0.80; p=0.015). Conclusion: Chronic inflammation in biopsy tissue might serve as a predicted factor for low incidence risk of PCa. Surgery Oncology chronic inflammation prostate antigen density prostate cancer Introduction According to the American Cancer Society,prostate cancer(PCa) was the most common cancer among men in 2015, which was the second leading cause of tumor deaths in American men during the same period[ 1 ]. PCa mortality in South America and South Africa is much higher than in Asia[ 2 ]. Prostate-Specific Antigen (PSA) is the most valuable and universal serological marker currently used to screen for PCa[ 3 ]. However, in the clinical application of PSA test, we are often misled by the abnormal increase in PSA due to other factors[ 4 , 5 ].Prostate inflammation is one of the most common causes of abnormally elevated PSA, including asymptomatic or chronic prostatitis[ 6 , 7 ], which is one of the most important factors that cause unnecessary biopsy in a large number of patients[ 8 ]. A bacterial infection caused inflammation of the prostate, causing damage to prostate epithelial cells and further causing malignant of prostate cells, which may be one of the mechanisms[ 9 ]. Although chronic inflammation is common in biopsy tissues, its mechanism in the development of PCa is still unclear[ 9 ]. Therefore, to further investigate whether inflammation had a significant relationship with the incidence risk of PCa, we performed this study. Patients And Methods We retrospectively analyzed the records of 831 patients who underwent transperineal prostate biopsy for the first time in Tianjin medical University Second Hospital from January 2016 to January 2019. A total of 686 patients were included in this study after main included criteria were as follows: 1) abnormal digital rectal examination(DRE), 2) abnormal DRE and elevated PSA, 3) Abnormal DRE with normal PSA. The main exclusions of distant metastases, had less than 14 needles, had a previous history of prostate surgery, had urinary tract infections, and also those who were on a catheter. Collection and use of patient data. All data of patients were collected and analyzed retrospectively. Including the age (years) and body mass index (BMI, kg/m 2 ) of each patient. PSA was measured by immuno-radiation test (normal range: 0-4ng/ml). Use TRUS to measure prostate volume and TZ before biopsy. Use collected data to calculate PSA density(PSAD). Each biopsy core needed to be systematically evaluated by an experienced pathologist use the following issues: Chronic inflammation criteria included the following findings: (1) Inflammatory cells infiltrate the prostate matrix;(2) Inflammatory cell infiltration is mainly composed of lymphocytes and mixed plasma cells, and (3) Distribution around cell infiltration. Statistical analysis We used SPSS.22 to statistically analyze the data, used mean ± SD to represent continuous variables, chi-square test to compare binary variables, univariate and multivariate analysis to select independent risk factors. All p < 0.05 was considered statistically significant. Results Of the 686 patients included, 407 (59%) patients had chronic inflammation in prostate, 354 (51.6%) patients were diagnosed PCa, and 332(48.4%) patients were diagnosed the benign group. In Table 1, we had shown baseline clinical characteristics of our cohort. Comparing the clinical characteristics of PCa and the benign group, we found that age is not an important factor in predicting the risk of prostate cancer(p = 0.97). Chronic inflammation of the prostate could reduce the risk of PCa(p༜0.001). And we also observed that patients with smaller PV and TZ had low incidence of PCa. Serum PSA levels(p = 0.022) and PSA density (PSAD)(p < 0.001) were also significantly higher in the PCa group than the benign group in univariate analysis. In multivariate analyses, chronic inflammation played an important role in the incidence of PCa(OR = 0.8; p = 0.015) in Table 2. In addition, we also found that the higher PSAD, the greater the incidence risk of PCa(p༜0.001). Also, The ROC curves of PSAD was 0.45 (area under curve 0.85, sensitivity 0.75, specificity 0.86). Discussion In our study, we demonstrated that chronic inflammation was inversely related to the incidence of PCa. We concluded that inflammation of prostate puncture tissue may reduce the probability of malignant transformation of prostate gland epithelium. At present, inflammation was an important factor in the occurrence and development of many malignant tumors. Cervical cancer, HCC, esophageal cancer, and gastric cancer all have clear models about the relationship between inflammation and tumor progression. However, the specific relationship between inflammation and the occurrence and progression of PCa remains unclear. Gurel et al found that chronic inflammation was associated with a higher incidence of PCa [ 10 ], while large clinical trial data reported by Moreira et al presented that chronic inflammation was independently associated with low incidence risk of PCa [ 11 ]. Besides, there were some researches showed that inflammation might not play a role in the incidence of PCa [ 12 – 14 ]. We had recognized that chronic inflammation in the prostate may cause proliferative inflammatory atrophy (PIA) and that PIA was associated with high-grade prostate intraepithelial neoplasia (HGPIN). Bills et al found that PIA enhanced the progression of PCa [21], while Brasil et al evaluated 100 radical prostatectomy specimens and found there was no significant association between PIA and PCa[ 10 ]. Coussens et al proposed the close connection between chronic inflammation and gastric, liver, colon, and bladder cancer[ 14 ]. For suppressing the inflammatory response, the risk of tumorigenesis could be further reduced[ 15 ]. Deu to chronic inflammation was related to oxidative stress-mediated by the cyclooxygenase gene pathway, inhibiting this pathway may reduce the risk of cancers. Observational studies of PCa suggested that NSAID might play a protective factor in reducing the incidence of PCa[ 17 ]. However, the protective effects of NSAIDs had been challenged and questioned in other studies, they had shown an increasing risk of PCa after taking NSAIDs [ 18 , 19 ]. Therefore, our conclusion still needed to be further verified, and we should consider whether there was a difference in the impact of inflammation on prostate cells in different ranges of PSA levels. There are several limitations to the present study. First, The number of subjects included in this study is small, and a large number of multicenter studies are still needed to confirm our conclusion. Also, we only found that inflammation may affect the incidence of PCa, but did not further consider whether the inflammation affected the occurrence of Gleason score. In addition, we only selected patients with patients with PSA 4-50ng/ml for study, and did not conduct stratified study on different PSA range. Conclusion The main view was that chronic inflammation might have a protective effect on reducing the incidence of PCa, and be independently associated with low-grade PCa in patients. The second conclusion was that the combination of PSAD and inflammation could reduce the number of unnecessary repeat biopsy. Declarations Ethics approval The study was approved by the Regional Ethical Review Board in Tianjin medical university second hospital. Consent for publication Not applicable. Competing interests The authors declare no conflict of interest. Funding This project was support by: Tianjin Science and technology committee(19ZXDBSY00050). The founding bodies had no influence on the design of the study, data collection, data analysis, and interpretation of data; or writing of the manuscript. Authors’ contributions Conception and Design: JZ and RL; Extraction of Data: GS and JZ; Drafting the Article: JZ and GS; Revising It for Intellectual Content: JZ, RL; Final Approval of the Completed Article: JZ, GS, RL. All authors read and approved the final manuscript. Acknowledgments We owe our thanks to Guangyu Sun and Jiatong Zhou for their work on revising and data extracting in this manuscript. Further information Not applicable. Availability of data and materials All data generated or analyzed during this study are included in this References Chen W, Zheng R, Baade PD, Zhang S, Zeng H, Bray F, Jemal A, Yu XQ, He J. CA Cancer J Clin CA: a cancer journal for clinicians. 2016;66(2):115–32. Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136(5):E359–86. Stephan C, Jung K, Lein M, Diamandis EP. PSA and other tissue kallikreins for prostate cancer detection. Eur J Cancer. 2007;43(13):1918–26. Oesterling JE. Prostate specific antigen: a critical assessment of the most useful tumor marker for adenocarcinoma of the prostate. J Urol. 1991;145(5):907–23. Stamey TA, Yang N, Hay AR, McNeal JE, Freiha FS, Redwine E. Prostate-specific antigen as a serum marker for adenocarcinoma of the prostate. N Engl J Med. 1987;317(15):909–16. Okada K, Kojima M, Naya Y, Kamoi K, Yokoyama K, Takamatsu T, Miki T. Correlation of histological inflammation in needle biopsy specimens with serum prostate- specific antigen levels in men with negative biopsy for prostate cancer. Urology. 2000;55(6):892–8. Chang SG, Kim CS, Jeon SH, Kim YW, Choi BY. Is chronic inflammatory change in the prostate the major cause of rising serum prostate-specific antigen in patients with clinical suspicion of prostate cancer? Int J Urol. 2006;13(2):122–6. Catalona WJ, Smith DS, Ratliff TL, Dodds KM, Coplen DE, Yuan JJ, Petros JA, Andriole GL. Measurement of prostate-specific antigen in serum as a screening test for prostate cancer. N Engl J Med. 1991;324(17):1156–61. Sfanos KS, De Marzo AM. Prostate cancer and inflammation: the evidence. Histopathology. 2012;60(1):199–215. Wang W, Bergh A, Damber JE. Morphological transition of proliferative inflammatory atrophy to high-grade intraepithelial neoplasia and cancer in human prostate. Prostate. 2009;69(13):1378–86. Porcaro AB, Novella G, Mattevi D, Bizzotto L, Cacciamani G, Luyk ND, Tamanini I, Cerruto MA, Brunelli M, Artibani W. Chronic Inflammation in Prostate Biopsy Cores is an Independent Factor that Lowers the Risk of Prostate Cancer Detection and is Inversely Associated with the Number of Positive Cores in Patients Elected to a First Biopsy. Curr Urol. 2016;9(2):82–92. Kuang AG, Nickel JC, Andriole GL, Castro-Santamaria R, Freedland SJ, Moreira DM. Both acute and chronic inflammation are associated with less perineural invasion in men with prostate cancer on repeat biopsy. BJU Int. 2019;123(1):91–7. Thun MJ, Henley SJ, Patrono C. Nonsteroidal anti-inflammatory drugs as anticancer agents: mechanistic, pharmacologic, and clinical issues. J Natl Cancer Inst. 2002;94(4):252–66. Gridley G, McLaughlin JK, Ekbom A, Klareskog L, Adami HO, Hacker DG, Hoover R, Fraumeni JF Jr. Incidence of cancer among patients with rheumatoid arthritis. J Natl Cancer Inst. 1993;85(4):307–11. De Marzo AM, Platz EA, Sutcliffe S, Xu J, Grönberg H, Drake CG, Nakai Y, Isaacs WB, Nelson WG. Inflammation in prostate carcinogenesis. Nat Rev Cancer. 2007;7(4):256–69. Strawson J. Nonsteroidal anti-inflammatory drugs and cancer pain. Curr Opin Support Palliat Care. 2018;12(2):102–7. Langman MJ, Cheng KK, Gilman EA, Lancashire RJ. Effect of anti-inflammatory drugs on overall risk of common cancer: case-control study in general practice research database. BMJ. 2000;320(7250):1642–6. Dennis LK, Lynch CF, Torner JC. Epidemiologic association between prostatitis and prostate cancer. Urology. 2002;60(1):78–83. Murtola TJ, Gurel B, Umbehr M, Lucia MS, Thompson IM Jr, Goodman PJ, Kristal AR, Parnes HL, Lippman SM, Sutcliffe S, Peskoe SB, Barber JR, Drake CG, Nelson WG, De Marzo AM, Platz EA. Inflammation in Benign Prostate Tissue and Prostate Cancer in the Finasteride Arm of the Prostate Cancer Prevention Trial. Cancer Epidemiol Biomarkers Prev. 2016;25(3):463–9. Ekbom A, Helmick C, Zack M, Adami HO. Ulcerative colitis and colorectal cancer. A population-based study. N Engl J Med. 1990;323(18):1228–33. Tables Table 1 Characteristics of the study population are summarized Abbreviation: PCa, prostate cancer; tPSA, total prostate specific antigen; PSAD, prostate specific antigen density; OR, odds ratio PCa(n=354) Benign（n =332） OR p Age(years) 70.7 ± 65.30 73.9 ± 60.80 1.18 0.97 tPSA (ng/mL), mean ± SD 22.1 ± 9.80 16.1 ± 7.80 2.5 0.022 Prostate volume (mL), mean ± SD 32.4 ± 16.70 54.7 ± 20.0 0.95 <0.001 Transition zone (mL), mean ± SD 17.6 ± 13.40 35.5 ± 14.6 0.9 <0.001 PSAD（ng / mL 2 ）, mean ± SD 0.83 ± 0.41 0.35 ± 0.23 16.42 <0.001 chronic inflammation 0.82 <0.001 YES 144 263 NO 210 69 Table 2 Univariate analysis and Multivariate analysis for risk factors for the incidence of PCa Abbreviation: tPSA, total prostate-specific antigen; PSAD, prostate-specific antigen density; OR, odds ratio Univariate analysis Multivariate analysis OR p OR p Age(years) 1.18 0.97 tPSA 2.5 0.022 1.68 0.06 Prostate volume 0.95 <0.001 0.99 0.08 Transition zone 0.9 <0.001 0.95 0.06 PSAD 16.42 <0.001 22.71 <0.001 chronic inflammation 0.82 <0.001 0.8 0.015 Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-258933","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":13269369,"identity":"e8242317-c504-45fc-99f2-60d4ab32ef9e","order_by":0,"name":"jiatong zhou","email":"","orcid":"","institution":"Tianjin Medical University Second Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"jiatong","middleName":"","lastName":"zhou","suffix":""},{"id":13269370,"identity":"ba70f1f9-7b09-404d-8730-59102cecaa32","order_by":1,"name":"guangyu sun","email":"","orcid":"","institution":"Tianjin Medical University Second Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"guangyu","middleName":"","lastName":"sun","suffix":""},{"id":13269371,"identity":"38f8857a-58f8-4124-97cc-afbecd25dd36","order_by":2,"name":"ranlu liu","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA5ElEQVRIiWNgGAWjYBACNvbmgw8+GNjw8MsfPvggoaKGsBY+nmPJhjMq0uQkZ7AlGzw4c4ywFjkJHzVpnjOHjQ1u8JhJPmxhJsJhEjwMErxtaYkzZ7elVSQ2sDHwt3cn4Nci3XvAQLLNJrFf5vCxG4k7ZBgkzpzdgF+LzLmEBEOQLQ1paTcSz7AxGEjkEtAikWNwILHtcOKGAzlmBYltzERpMWw4APZ+jhkDcVqAgczYAArknmPJEglnjvEQ9It8e/Px339AUQmM048/Kmrk+Nt78WvBADykKR8Fo2AUjIJRgBUAADmAT9f68d60AAAAAElFTkSuQmCC","orcid":"","institution":"Tianjin Medical University Second Hospital","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"ranlu","middleName":"","lastName":"liu","suffix":""}],"badges":[],"createdAt":"2021-02-20 12:18:55","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-258933/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-258933/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":13672876,"identity":"e6bfd482-a0ae-4cf1-8fa9-baed17d47038","added_by":"auto","created_at":"2021-09-17 11:15:14","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":164921,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-258933/v1/40de3c5a-f2c9-4b61-9130-bb619e86372e.pdf"}],"financialInterests":"","formattedTitle":"\u003cp\u003eChronic Inflammation on Prostate Needle Biopsy\u0026nbsp;as a Significant Predictor of the Lower Incidence Risk of Prostate Cancer\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eAccording to the American Cancer Society,prostate cancer(PCa) was the most common cancer among men in 2015, which was the second leading cause of tumor deaths in American men during the same period[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. PCa mortality in South America and South Africa is much higher than in Asia[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Prostate-Specific Antigen (PSA) is the most valuable and universal serological marker currently used to screen for PCa[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. However, in the clinical application of PSA test, we are often misled by the abnormal increase in PSA due to other factors[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].Prostate inflammation is one of the most common causes of abnormally elevated PSA, including asymptomatic or chronic prostatitis[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e], which is one of the most important factors that cause unnecessary biopsy in a large number of patients[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. A bacterial infection caused inflammation of the prostate, causing damage to prostate epithelial cells and further causing malignant of prostate cells, which may be one of the mechanisms[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Although chronic inflammation is common in biopsy tissues, its mechanism in the development of PCa is still unclear[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Therefore, to further investigate whether inflammation had a significant relationship with the incidence risk of PCa, we performed this study.\u003c/p\u003e"},{"header":"Patients And Methods","content":"\u003cp\u003eWe retrospectively analyzed the records of 831 patients who underwent transperineal prostate biopsy for the first time in Tianjin medical University Second Hospital from January 2016 to January 2019. A total of 686 patients were included in this study after main included criteria were as follows: 1) abnormal digital rectal examination(DRE), 2) abnormal DRE and elevated PSA, 3) Abnormal DRE with normal PSA.\u003c/p\u003e\u003cp\u003eThe main exclusions of distant metastases, had less than 14 needles, had a previous history of prostate surgery, had urinary tract infections, and also those who were on a catheter.\u003c/p\u003e\u003cp\u003eCollection and use of patient data.\u003c/p\u003e\u003cp\u003eAll data of patients were collected and analyzed retrospectively. Including the age (years) and body mass index (BMI, kg/m\u003csup\u003e2\u003c/sup\u003e) of each patient. PSA was measured by immuno-radiation test (normal range: 0-4ng/ml). Use TRUS to measure prostate volume and TZ before biopsy. Use collected data to calculate PSA density(PSAD).\u003c/p\u003e\u003cp\u003eEach biopsy core needed to be systematically evaluated by an experienced pathologist use the following issues: Chronic inflammation criteria included the following findings: (1) Inflammatory cells infiltrate the prostate matrix;(2) Inflammatory cell infiltration is mainly composed of lymphocytes and mixed plasma cells, and (3) Distribution around cell infiltration.\u003c/p\u003e\u003cdiv id=\"Sec2\" class=\"Section2\"\u003e\u003ch2\u003eStatistical analysis\u003c/h2\u003e\u003cp\u003eWe used SPSS.22 to statistically analyze the data, used mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD to represent continuous variables, chi-square test to compare binary variables, univariate and multivariate analysis to select independent risk factors. All p\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered statistically significant.\u003c/p\u003e\u003c/div\u003e"},{"header":"Results","content":" \u003cp\u003eOf the 686 patients included, 407 (59%) patients had chronic inflammation in prostate, 354 (51.6%) patients were diagnosed PCa, and 332(48.4%) patients were diagnosed the benign group. In Table\u0026nbsp;1, we had shown baseline clinical characteristics of our cohort. Comparing the clinical characteristics of PCa and the benign group, we found that age is not an important factor in predicting the risk of prostate cancer(p\u0026thinsp;=\u0026thinsp;0.97). Chronic inflammation of the prostate could reduce the risk of PCa(p༜0.001). And we also observed that patients with smaller PV and TZ had low incidence of PCa. Serum PSA levels(p\u0026thinsp;=\u0026thinsp;0.022) and PSA density (PSAD)(p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) were also significantly higher in the PCa group than the benign group in univariate analysis. In multivariate analyses, chronic inflammation played an important role in the incidence of PCa(OR\u0026thinsp;=\u0026thinsp;0.8; p\u0026thinsp;=\u0026thinsp;0.015) in Table\u0026nbsp;2. In addition, we also found that the higher PSAD, the greater the incidence risk of PCa(p༜0.001). Also, The ROC curves of PSAD was 0.45 (area under curve 0.85, sensitivity 0.75, specificity 0.86).\u003c/p\u003e "},{"header":"Discussion","content":" \u003cp\u003eIn our study, we demonstrated that chronic inflammation was inversely related to the incidence of PCa. We concluded that inflammation of prostate puncture tissue may reduce the probability of malignant transformation of prostate gland epithelium. At present, inflammation was an important factor in the occurrence and development of many malignant tumors. Cervical cancer, HCC, esophageal cancer, and gastric cancer all have clear models about the relationship between inflammation and tumor progression. However, the specific relationship between inflammation and the occurrence and progression of PCa remains unclear. Gurel et al found that chronic inflammation was associated with a higher incidence of PCa [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e], while large clinical trial data reported by Moreira et al presented that chronic inflammation was independently associated with low incidence risk of PCa [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Besides, there were some researches showed that inflammation might not play a role in the incidence of PCa [\u003cspan additionalcitationids=\"CR13\" citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. We had recognized that chronic inflammation in the prostate may cause proliferative inflammatory atrophy (PIA) and that PIA was associated with high-grade prostate intraepithelial neoplasia (HGPIN). Bills et al found that PIA enhanced the progression of PCa [21], while Brasil et al evaluated 100 radical prostatectomy specimens and found there was no significant association between PIA and PCa[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Coussens et al proposed the close connection between chronic inflammation and gastric, liver, colon, and bladder cancer[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. For suppressing the inflammatory response, the risk of tumorigenesis could be further reduced[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Deu to chronic inflammation was related to oxidative stress-mediated by the cyclooxygenase gene pathway, inhibiting this pathway may reduce the risk of cancers. Observational studies of PCa suggested that NSAID might play a protective factor in reducing the incidence of PCa[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. However, the protective effects of NSAIDs had been challenged and questioned in other studies, they had shown an increasing risk of PCa after taking NSAIDs [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Therefore, our conclusion still needed to be further verified, and we should consider whether there was a difference in the impact of inflammation on prostate cells in different ranges of PSA levels.\u003c/p\u003e \u003cp\u003eThere are several limitations to the present study. First, The number of subjects included in this study is small, and a large number of multicenter studies are still needed to confirm our conclusion. Also, we only found that inflammation may affect the incidence of PCa, but did not further consider whether the inflammation affected the occurrence of Gleason score. In addition, we only selected patients with patients with PSA 4-50ng/ml for study, and did not conduct stratified study on different PSA range.\u003c/p\u003e "},{"header":"Conclusion","content":" \u003cp\u003eThe main view was that chronic inflammation might have a protective effect on reducing the incidence of PCa, and be independently associated with low-grade PCa in patients. The second conclusion was that the combination of PSAD and inflammation could reduce the number of unnecessary repeat biopsy.\u003c/p\u003e "},{"header":"Declarations","content":"\u003cp\u003eEthics approval\u003c/p\u003e\n\u003cp\u003eThe study was approved by the Regional Ethical Review Board in Tianjin medical university second hospital.\u003c/p\u003e\n\u003cp\u003eConsent for publication\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003eCompeting interests\u003c/p\u003e\n\u003cp\u003eThe authors declare no conflict of interest.\u003c/p\u003e\n\u003cp\u003eFunding\u003c/p\u003e\n\u003cp\u003eThis project was support by: Tianjin Science and technology committee(19ZXDBSY00050). The founding bodies had no influence on the design of the study, data collection, data analysis, and interpretation of data; or writing of the manuscript.\u003c/p\u003e\n\u003cp\u003eAuthors\u0026rsquo; contributions\u003c/p\u003e\n\u003cp\u003eConception and Design: JZ and RL; Extraction of Data: GS and JZ;\u003c/p\u003e\n\u003cp\u003eDrafting the Article: JZ and GS; Revising It for Intellectual Content: JZ, RL; Final Approval of the Completed Article: JZ, GS, RL. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003eAcknowledgments\u003c/p\u003e\n\u003cp\u003eWe owe our thanks to Guangyu Sun and Jiatong Zhou for their work on revising and data extracting in this manuscript.\u003c/p\u003e\n\u003cp\u003eFurther information\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003eAvailability of data and materials\u003c/p\u003e\n\u003cp\u003eAll data generated or analyzed during this study are included in this\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eChen W, Zheng R, Baade PD, Zhang S, Zeng H, Bray F, Jemal A, Yu XQ, He J. CA Cancer J Clin CA: a cancer journal for clinicians. 2016;66(2):115\u0026ndash;32.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFerlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136(5):E359\u0026ndash;86.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eStephan C, Jung K, Lein M, Diamandis EP. PSA and other tissue kallikreins for prostate cancer detection. Eur J Cancer. 2007;43(13):1918\u0026ndash;26.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOesterling JE. Prostate specific antigen: a critical assessment of the most useful tumor marker for adenocarcinoma of the prostate. J Urol. 1991;145(5):907\u0026ndash;23.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eStamey TA, Yang N, Hay AR, McNeal JE, Freiha FS, Redwine E. Prostate-specific antigen as a serum marker for adenocarcinoma of the prostate. N Engl J Med. 1987;317(15):909\u0026ndash;16.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOkada K, Kojima M, Naya Y, Kamoi K, Yokoyama K, Takamatsu T, Miki T. Correlation of histological inflammation in needle biopsy specimens with serum prostate- specific antigen levels in men with negative biopsy for prostate cancer. Urology. 2000;55(6):892\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChang SG, Kim CS, Jeon SH, Kim YW, Choi BY. Is chronic inflammatory change in the prostate the major cause of rising serum prostate-specific antigen in patients with clinical suspicion of prostate cancer? Int J Urol. 2006;13(2):122\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCatalona WJ, Smith DS, Ratliff TL, Dodds KM, Coplen DE, Yuan JJ, Petros JA, Andriole GL. Measurement of prostate-specific antigen in serum as a screening test for prostate cancer. N Engl J Med. 1991;324(17):1156\u0026ndash;61.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSfanos KS, De Marzo AM. Prostate cancer and inflammation: the evidence. Histopathology. 2012;60(1):199\u0026ndash;215.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWang W, Bergh A, Damber JE. Morphological transition of proliferative inflammatory atrophy to high-grade intraepithelial neoplasia and cancer in human prostate. Prostate. 2009;69(13):1378\u0026ndash;86.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePorcaro AB, Novella G, Mattevi D, Bizzotto L, Cacciamani G, Luyk ND, Tamanini I, Cerruto MA, Brunelli M, Artibani W. Chronic Inflammation in Prostate Biopsy Cores is an Independent Factor that Lowers the Risk of Prostate Cancer Detection and is Inversely Associated with the Number of Positive Cores in Patients Elected to a First Biopsy. Curr Urol. 2016;9(2):82\u0026ndash;92.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKuang AG, Nickel JC, Andriole GL, Castro-Santamaria R, Freedland SJ, Moreira DM. Both acute and chronic inflammation are associated with less perineural invasion in men with prostate cancer on repeat biopsy. BJU Int. 2019;123(1):91\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eThun MJ, Henley SJ, Patrono C. Nonsteroidal anti-inflammatory drugs as anticancer agents: mechanistic, pharmacologic, and clinical issues. J Natl Cancer Inst. 2002;94(4):252\u0026ndash;66.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGridley G, McLaughlin JK, Ekbom A, Klareskog L, Adami HO, Hacker DG, Hoover R, Fraumeni JF Jr. Incidence of cancer among patients with rheumatoid arthritis. J Natl Cancer Inst. 1993;85(4):307\u0026ndash;11.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDe Marzo AM, Platz EA, Sutcliffe S, Xu J, Gr\u0026ouml;nberg H, Drake CG, Nakai Y, Isaacs WB, Nelson WG. Inflammation in prostate carcinogenesis. Nat Rev Cancer. 2007;7(4):256\u0026ndash;69.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eStrawson J. Nonsteroidal anti-inflammatory drugs and cancer pain. Curr Opin Support Palliat Care. 2018;12(2):102\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLangman MJ, Cheng KK, Gilman EA, Lancashire RJ. Effect of anti-inflammatory drugs on overall risk of common cancer: case-control study in general practice research database. BMJ. 2000;320(7250):1642\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDennis LK, Lynch CF, Torner JC. Epidemiologic association between prostatitis and prostate cancer. Urology. 2002;60(1):78\u0026ndash;83.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMurtola TJ, Gurel B, Umbehr M, Lucia MS, Thompson IM Jr, Goodman PJ, Kristal AR, Parnes HL, Lippman SM, Sutcliffe S, Peskoe SB, Barber JR, Drake CG, Nelson WG, De Marzo AM, Platz EA. Inflammation in Benign Prostate Tissue and Prostate Cancer in the Finasteride Arm of the Prostate Cancer Prevention Trial. Cancer Epidemiol Biomarkers Prev. 2016;25(3):463\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eEkbom A, Helmick C, Zack M, Adami HO. Ulcerative colitis and colorectal cancer. A population-based study. N Engl J Med. 1990;323(18):1228\u0026ndash;33.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTable 1 Characteristics of the study population are summarized Abbreviation: PCa, prostate cancer; tPSA, total prostate specific antigen; PSAD, prostate specific antigen density; OR, odds ratio\u003c/p\u003e\n\u003ctable border=\"1\" width=\"0\"\u003e\n\u003ctbody\u003e\n\u003ctr style=\"height: 37px;\"\u003e\n\u003ctd style=\"height: 37px;\" width=\"203\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 37px;\" width=\"153\"\u003e\n\u003cp\u003ePCa(n=354)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 37px;\" width=\"175\"\u003e\n\u003cp\u003eBenign（n =332）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 37px;\" width=\"175\"\u003e\n\u003cp\u003eOR\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 37px;\" width=\"69\"\u003e\n\u003cp\u003ep\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\" width=\"203\"\u003e\n\u003cp\u003eAge(years)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" width=\"153\"\u003e\n\u003cp\u003e70.7\u0026nbsp; \u0026plusmn;\u0026nbsp; 65.30\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" width=\"175\"\u003e\n\u003cp\u003e73.9\u0026nbsp; \u0026plusmn;\u0026nbsp; 60.80\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" width=\"175\"\u003e\n\u003cp\u003e1.18\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" width=\"69\"\u003e\n\u003cp\u003e0.97\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\" width=\"203\"\u003e\n\u003cp\u003etPSA (ng/mL), mean \u0026plusmn; SD\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" width=\"153\"\u003e\n\u003cp\u003e22.1\u0026nbsp; \u0026plusmn;\u0026nbsp; 9.80\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" width=\"175\"\u003e\n\u003cp\u003e16.1\u0026nbsp; \u0026plusmn;\u0026nbsp; 7.80\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" width=\"175\"\u003e\n\u003cp\u003e2.5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" width=\"69\"\u003e\n\u003cp\u003e0.022\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\" width=\"203\"\u003e\n\u003cp\u003eProstate volume (mL), mean \u0026plusmn; SD\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" width=\"153\"\u003e\n\u003cp\u003e32.4\u0026nbsp; \u0026plusmn;\u0026nbsp; 16.70\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" width=\"175\"\u003e\n\u003cp\u003e54.7\u0026nbsp; \u0026plusmn;\u0026nbsp; 20.0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" width=\"175\"\u003e\n\u003cp\u003e0.95\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" width=\"69\"\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\" width=\"203\"\u003e\n\u003cp\u003eTransition zone (mL), mean \u0026plusmn; SD\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" width=\"153\"\u003e\n\u003cp\u003e17.6\u0026nbsp; \u0026plusmn;\u0026nbsp; 13.40\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" width=\"175\"\u003e\n\u003cp\u003e35.5\u0026nbsp; \u0026plusmn;\u0026nbsp; 14.6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" width=\"175\"\u003e\n\u003cp\u003e0.9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" width=\"69\"\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 38px;\"\u003e\n\u003ctd style=\"height: 38px;\" width=\"203\"\u003e\n\u003cp\u003ePSAD（ng / mL\u003csup\u003e2\u003c/sup\u003e）, mean \u0026plusmn; SD\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 38px;\" width=\"153\"\u003e\n\u003cp\u003e0.83\u0026nbsp; \u0026plusmn;\u0026nbsp; 0.41\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 38px;\" width=\"175\"\u003e\n\u003cp\u003e0.35\u0026nbsp; \u0026plusmn;\u0026nbsp; 0.23\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 38px;\" width=\"175\"\u003e\n\u003cp\u003e16.42\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 38px;\" width=\"69\"\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\" width=\"203\"\u003e\n\u003cp\u003echronic inflammation\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" width=\"153\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" width=\"175\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" width=\"175\"\u003e\n\u003cp\u003e0.82\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" width=\"69\"\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\" width=\"203\"\u003e\n\u003cp\u003eYES\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" width=\"153\"\u003e\n\u003cp\u003e144\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" width=\"175\"\u003e\n\u003cp\u003e263\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" width=\"175\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" width=\"69\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\" width=\"203\"\u003e\n\u003cp\u003eNO\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" width=\"153\"\u003e\n\u003cp\u003e210\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" width=\"175\"\u003e\n\u003cp\u003e69\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" width=\"175\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" width=\"69\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 2 Univariate analysis and Multivariate analysis for risk factors for the incidence of PCa\u003c/p\u003e\n\u003cp\u003eAbbreviation: tPSA, total prostate-specific antigen; PSAD, prostate-specific antigen density; OR, odds ratio\u003c/p\u003e\n\u003ctable border=\"1\"\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"4\" width=\"435\"\u003e\n\u003cp\u003e \u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"3\" width=\"136\"\u003e\n\u003cp\u003eUnivariate\u003c/p\u003e\n\u003cp\u003eanalysis\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"3\" width=\"260\"\u003e\n\u003cp\u003eMultivariate analysis\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"217\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"56\"\u003e\n\u003cp\u003eOR\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"80\"\u003e\n\u003cp\u003ep\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" width=\"94\"\u003e\n\u003cp\u003eOR\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"3\" width=\"165\"\u003e\n\u003cp\u003ep\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" width=\"217\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"4\" width=\"435\"\u003e\n\u003cp\u003eAge(years)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" width=\"56\"\u003e\n\u003cp\u003e1.18\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"80\"\u003e\n\u003cp\u003e0.97\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" width=\"94\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"165\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"4\" width=\"435\"\u003e\n\u003cp\u003etPSA\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" width=\"56\"\u003e\n\u003cp\u003e2.5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"80\"\u003e\n\u003cp\u003e0.022\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" width=\"94\"\u003e\n\u003cp\u003e1.68\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"165\"\u003e\n\u003cp\u003e0.06\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"4\" width=\"435\"\u003e\n\u003cp\u003eProstate volume\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" width=\"56\"\u003e\n\u003cp\u003e0.95\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"80\"\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" width=\"94\"\u003e\n\u003cp\u003e0.99\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"165\"\u003e\n\u003cp\u003e0.08\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"4\" width=\"435\"\u003e\n\u003cp\u003eTransition zone\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" width=\"56\"\u003e\n\u003cp\u003e0.9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"80\"\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" width=\"94\"\u003e\n\u003cp\u003e0.95\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"165\"\u003e\n\u003cp\u003e0.06\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"4\" width=\"435\"\u003e\n\u003cp\u003ePSAD\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" width=\"56\"\u003e\n\u003cp\u003e16.42\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"80\"\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" width=\"94\"\u003e\n\u003cp\u003e22.71\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"165\"\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"4\" width=\"435\"\u003e\n\u003cp\u003echronic inflammation\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" width=\"56\"\u003e\n\u003cp\u003e0.82\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"80\"\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" width=\"94\"\u003e\n\u003cp\u003e0.8\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"165\"\u003e\n\u003cp\u003e0.015\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"chronic inflammation, prostate antigen density, prostate cancer ","lastPublishedDoi":"10.21203/rs.3.rs-258933/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-258933/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003ePurpose: At present, there is no clear relationship between prostatitis and prostate cancer(PCa). Therefore, in order to further understand the inflammation of prostate tissue and the occurrence of PCa, we conducted this study.\u003c/p\u003e\u003cp\u003eMethod: A total of 686 patients were enrolled in the study. All patients underwent prostate biopsy in our hospital. A retrospective analysis of the biopsy results was performed to assess the assocition between chronic inflammation and the risk of PCa.\u003c/p\u003e\u003cp\u003eResult: Of the 686 patients, 354 were diagnosed with PCa, and 332 were benign. A total of 403 patients had prostate inflammation. PCa patients had lower prostate volume and transition zone volume than benign group(p＜0.001). Compared with benign group, PCa patients had lower PSA and PSA density (PSAD)(p＜0.001). We also found that the probability of inflammation in PCa patients is lower than that in the benign group (p＜0.001). In multivariate analyses, chronic inflammation was negatively correlated with the incidence of PCa（OR=0.80; p=0.015). Conclusion: Chronic inflammation in biopsy tissue might serve as a predicted factor for low incidence risk of PCa.\u0026nbsp;\u003c/p\u003e","manuscriptTitle":"Chronic Inflammation on Prostate Needle Biopsy\u0026nbsp;as a Significant Predictor of the Lower Incidence Risk of Prostate Cancer","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2021-02-25 21:56:43","doi":"10.21203/rs.3.rs-258933/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"96851535-b70a-499d-9b59-8d36d491e848","owner":[],"postedDate":"February 25th, 2021","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":2617508,"name":"Surgery"},{"id":2617509,"name":"Oncology"}],"tags":[],"updatedAt":"2021-03-31T14:03:23+00:00","versionOfRecord":[],"versionCreatedAt":"2021-02-25 21:56:43","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-258933","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-258933","identity":"rs-258933","version":["v1"]},"buildId":"7rjqhiLT3MXkJMwkYKINL","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}