Author: Dr. Zhang

Source: Oncology Channel in www.yxj.org.cn

Prostatitis, a common disease of urinary surgery, is officially recorded as “TOP ONE” urological diseases of male below 50 years old, which commonly manifests as frequent urination, urgent urination, endless urination, etc.

 

It is widely known that prostate cancer has become one of the most common malignant tumors of male in many countries around the world with a growing trend of morbidity year by year, and that the majority of prostate cancer patients are already at middle-to-advanced stage upon the first diagnosis, inevitably leaving no chance of effective treatment. As a result, people have paid much greater attention to potential risk factors and early prevention of prostate cancer today. As indicated in recent years’ researches, prostatitis has proved to be a high risk factor of prostate cancer, which could be viewed as a “hotbed” of prostate cancerization.
 

Four Theoretical Relations between Prostatitis and Prostate Cancer

1. Inflammatory Response Could Induce Canceration of Prostatic Tissues

 

Inflammatory response-induced epidermal tissue damage and cell regeneration are universally believed as the critical factors of prostate oncogenesis.

 

As shown in the “damage-regeneration” model, inflammatory cells and macrophages that release nitrogen and active oxygen would cause viral and bacterial infection, and generate irritant agents like 2-amino-1-methyl-6-phenyl imidazopyridine. Such tissue damages, moreover, could induce regeneration and proliferation of epithelial cells. And since such “regeneration reaction” would finally end in replacement of damaged epithelial cells, which morphologically manifests as lesion atrophy of different forms, proliferative inflammatory atrophy would be formed accordingly at last. 
 

It is additionally worth noting that continuous exposure of inflammatory tissues to active oxygen and adverse effects of unhealthy diet and environmental toxins would unavoidably lead to higher possibility of gene mutation and chromosome aberration, and finally results in oncogenesis and further condition progression.

 

2、Morphological Relation

 

Prostatitis-induced cystic atrophy is closely linked to prostatic precancerous lesions. From a pathological section of atrophic tissues, we could find out atypical hyperplasia of epithelial cells which are commonly featured as nucleus enlargement, hyperchromasia and clearly-displayed nucleolus. 

 

3、Etiological Relation

 

It is believed that prostate oncogenesis might be involved with the germ infected and associated inflammatory response. According to the latest researches, there is evidence that prostate cancer has a positive correlation with viral infection, direct pathogen infection, sexually-transmitted disease, multiple sexual partners, frequent sexual life, and infection-related persistent inflammatory response.

 

4、Molecular Relation

 

Immunohistochemical result of proliferative inflammatory atrophic tissues has found out that there exists no expression or weak expression of specific keratin of basal cell 34βE12 in inflammatory atrophic cells, while that PSA and prostate-specific acid phosphatase are, however, highly expressed in proliferative inflammatory atrophic cells, which means that serum PSA level has a significant positive correlation with the degree of prostatic inflammatory atrophy (this immunohistochemical test, marked with damage degree of prostatic cells or integrity of basal cells, made a close observation on the cell growth-related protein expressed, cell differentiation and aging, regulation of carcinogenic substance and apoptosis.
 

Meanwhile, since P16, P27, and P53 in inflammatory cells are differently expressed from normal cells, prostate inflammation has further turned out to be closely related with prostate cancer.

 

Prostatitis has currently been verified as one of potential high-risk factor of prostate canceration by morphology, etiology, cellular and molecular level, but it is worth mentioned that there still exists certain limitations in relevant researches of this field such as undefined diagnostic criteria of prostatitis, delayed diagnosis and treatment of some prostatitis patients, confidential information of most STD patients, etc.

 

Considering undetermined occurrence and development mechanism of prostatitis-induced prostate cancer, further in-depth researches are still needed indeed to reduce incidence rate of prostate cancer in advance and to bring benefits to the mass of men’s health.