Vol. 46 (4): 545-556, July – August, 2020
Antonio B. Porcaro 1, Alessandro Tafuri 1, 2, Marco Sebben 1, Giovanni Novella 1, Tania Processali 1, Marco Pirozzi 1, Nelia Amigoni 1, Riccardo Rizzetto 1, Aliasger Shakir 2, Matteo Brunelli 3, Maria Angela Cerruto 1, Filippo Migliorini 1, Salvatore Siracusano 1, Walter Artibani 1
1 Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy; 2 USC Institute of Urology, and Catherine and Joseph Aresty, Department of Urology, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA, USA; 3 Department of Pathology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
Objective: To assess the association between prostate volume index (PVI), and prostatic chronic inflammation (PCI) as predictors of prostate cancer (PCA). PVI is the ratio between the central transition zone volume (CTZV) and the peripheral zone volume (PZV).
Materials and methods: Parameters evaluated included age, prostate specific antigen (PSA), total prostate volume (TPV), PSA density (PSAD), digital rectal exam (DRE), PVI, PCI and number of positive cores (NPC). All patients underwent baseline 14-core, trans-perineal random biopsies. Associations of parameters with the NPC were investigated by univariate and multivariate linear regression analysis.
Results: Between September 2010 to September 2017, 945 patients were evaluated. PCA was detected in 477 cases (50.7%), PCI in 205 cases (21.7%). PCA patients, compared to negative cases, were older (68.3 vs. 64.4 years) with smaller TPV (36 vs. 48.3mL) and CTZV (19.2 vs. 25.4), higher PSAD (0.24 vs. 0.15ng/mL/mL), further PVI values were lower (0.9 vs. 1.18) and biopsy cores less frequently involved by PCI (9.4% vs. 34.2%).
High PVI and the presence of PCI were independent negative predictors of NPC in model I considering PSA and TVP (PVI, regression coefficient, RC -0,6; p=0.002) and PCI (RC -1,4; p <0.0001); and in model II considering PSAD (PVI:RC -0,7; p <0,0001; and PCI: RC -1,5; p <0.0001).
Conclusions: High PVI and the presence of PCI lowered the mean rate of NPC and is associated with less aggressive tumor biology expressed by low tumor burden. PVI can give prognostic information before planning baseline random biopsies. Confirmatory studies are required.
Keywords: Prostatic Neoplasms; Prostate; Prostate-Specific Antigen