title: Does an inflammatory pattern at primary biopsy suggest a lower risk for prostate cancer at repeated saturation prostate biopsy?
abstract: BACKGROUND
  To evaluate if an inflammatory pattern at primary biopsy is associated with a lower risk for cancer in men submitted to repeated saturation prostate biopsy (SPBx).
  
  
  METHODS
  From January 2005 to January 2010, 320 patients, after a negative primary extended biopsy (median 18 cores), underwent SPBx by transperineal approach performing 27 cores (median). 210 (65.6%) patients had a normal parenchyma and 110 had an inflammatory pattern (34.4%) at primary biopsy (none of them complained of symptoms suggesting a diagnosis of acute prostatitis at the time of biopsy). Moreover, median prostate-specific antigen and abnormal digital rectal examination was equal to 7.3 ng/ml and 3.6% versus 8.2 ng/ml and 3.8%, respectively.
  
  
  RESULTS
  Prostate cancer (PCa) was found in 66 (20.5%) of 320 patients. Of these, 42 (63.6%) and 24 (36.4%; p = 0.007) had a histological diagnosis of chronic prostatitis and normal parenchyma at primary biopsy, respectively.
  
  
  CONCLUSIONS
  An inflammatory pattern at primary biopsy is not associated with a decrease in PCa incidence at repeated SPBx; therefore, only an accurate clinical evaluation including more parameters (i.e. urinary PCA3) could hopefully select men who need to undergo rebiopsy in the presence of persistent suspicion of cancer.
authors.affiliation: Urology Unit, Cannizzaro Hospital, Catania, Italy. piepepe@hotmail.com
authors.forename: Pietro
authors.initials: P
authors.lastname: Pepe
authors.forename: Francesco
authors.initials: F
authors.lastname: Aragona
mesh_terms: D001706:Biopsy / Q000379:methods*; D049109:Cell Proliferation; D006801:Humans; D007249:Inflammation; D008297:Male; D008495:Medical Oncology / Q000379:methods; D017430:Prostate-Specific Antigen / Q000096:biosynthesis; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000473:pathology*; D011472:Prostatitis / Q000473:pathology; D015203:Reproducibility of Results; D012189:Retrospective Studies
chemical_list: D017430:Prostate-Specific Antigen