title: Topographic and quantitative relationship between prostate inflammation, proliferative inflammatory atrophy and low-grade prostate intraepithelial neoplasia: a biopsy study in chronic prostatitis patients.
abstract: Inflammatory processes are important components in the pathogenesis of many             human cancers. According to the 'injury and regeneration' model for prostate carcinogenesis,             injury caused by pathogens or pro-inflammatory cytotoxic agents would trigger             proliferation of prostatic glandular cells, leading to the appearance of epithelial             lesions named 'Proliferative Inflammatory Atrophy' (PIA). Inflammatory cells infiltrating             the prostate would release genotoxic reactive oxygen species, leading atrophic             cells to neoplastic progression. The hypothesis pointing to PIA as risk-lesion             for prostate cancer has been extensively investigated at the cellular and molecular             levels, but few morphological data are available linking PIA or prostatic intraepithelial             neoplasia (PIN) to inflammation or clinical prostatitis. We investigated at the             morphological level 1367 prostate biopsies from 98 patients with a recent history             of chronic prostatitis, and 32 patients with biopsies positive for carcinoma.             Our results show that i) PIA is found more frequently in biopsy cores containing             a severe or moderate inflammatory focus, compared to NON-PIA lesions (partial             or cystic atrophy); ii) the PIA lesion post-atrophic hyperplasia is more frequently             found in tissues showing mild or no inflammation; iii) the extent of PIA per patient             correlates with the burden of moderate or severe inflammation, whereas NON-PIA             lesions do not; iv) low-grade PIN is in over 90% of cases emerging from normal,             non-atrophic glands and is more frequently found in biopsy cores with absent or             mild inflammatory burden; v) the inverse relationship between the prevalence of             low-grade PIN and the extent of PIA lesions per patient is described by a power             law function, suggesting the low likelihood of the concomitant presence of these             lesions in the same tissue; vi) NON-PIA lesions correlate inversely with neoplasia             in patients with prostate cancer; vii) the total scores of the NIH-CPSI questionnaire             correlate with both PIA and inflammation burdens at diagnosis of prostatitis but             not after pharmacological intervention. These results point to a positive association             between tissue inflammation, clinical prostatitis and the putative cancer risk-lesion             PIA, but do not support a model whereby low-grade PIN would arise from PIA.
authors.affiliation: Section of Histology, Department of Basic Medical Sciences, Ghent                     University, Ghent, Belgium.
authors.forename: A
authors.initials: A
authors.lastname: Vral
authors.forename: V
authors.initials: V
authors.lastname: Magri
authors.forename: E
authors.initials: E
authors.lastname: Montanari
authors.forename: G
authors.initials: G
authors.lastname: Gazzano
authors.forename: V
authors.initials: V
authors.lastname: Gourvas
authors.forename: E
authors.initials: E
authors.lastname: Marras
authors.forename: G
authors.initials: G
authors.lastname: Perletti
mesh_terms: D001284:Atrophy; D001706:Biopsy; D006801:Humans; D008297:Male; D011467:Prostate / Q000473:pathology*; D019048:Prostatic Intraepithelial Neoplasia / Q000453:epidemiology / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000453:epidemiology / Q000473:pathology; D011472:Prostatitis / Q000453:epidemiology / Q000473:pathology*; D019371:Topography, Medical