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Abstract 39

Association of Prostatitis with BPH or Prostate Cancer

AD Seftel, RN Rao, GT MacLennan, Ml Resnick

Case Western Reserve University,
Department of Urology and Pathology,
Cleveland, OH

The relationship between prostatitis and benign prostatic hyperplasia (BPH) and prostate cancer (PCa) was examined, based on the hypothesis that there may be an association between prostatitis and these other entities and that this association may involve upregulation of inducible nitric oxide synthase.

Forty (40) whole mount prostatectomy specimens were examined for the presence and distribution of a chronic inflammatory infiltrate. H & E staining was carried out, as well as immunostaining for inducible nitric oxide synthase. The site of inflammation was determined along with any relationship to BPH or PCa.

Inflammation was seen in all 40 cases, with peripheral zone inflammation in 38/40 specimens (95%) and transition zone inflammation in 35/40 cases (87.5%), without a predilection for either zone. In the cases with transition zone inflammation, the infiltrate was noted within and around BPH. Thus, inflammation involving BPH nodules affected the nodule proper and the adjacent non-adenomatous tissue. Inflammatory infiltrate was associated with PCa in only 23/40 cases (57.5%). In these cases, there was no association between the inflammation and the grade of Pca. INOS staining was present in low levels in both PCa and BPH, with minimal upregulation in the regions of inflammation.

These data suggest that while chronic inflammation in the prostate is associated with both BPH and prostate cancer, it has a greater tendency to be associated with BPH. There is no correlation between the grade of PCa and the inflammation. iNOS did not appear to discriminate between prostatitis, BPH and Pca.

(Supported by the Arthur Sullivan Foundation)