Can Prostatic Calcifications in the Peripheral Zone be Predictors of Prostate Cancer During Diagnostic Transrectal Ultrasound-Guided Needle Biopsy of the Prostate?

Özet

Introduction: Prostatic calculi are generally associated with benign prostatic hyperplasia and chronic inflammation of the gland. Many studies have reported that prostatic calcifications (PCs) and inflammatory processes are involved in the pathogenesis of prostate cancer (PCa). In the present study, we evaluated the frequency of finding PCs in the peripheral prostatic zone during transrectal ultrasound (TRUS) and its relationship with histologic results of the biopsy. Methods: In total, 156 patients with prostate-specific antigen (PSA) levels >2.5 ng/ml and/or abnormal digital rectal examination findings who presented in the urology policlinics of the Bağcılar Training and Research Hospital underwent TRUS-guided prostate needle biopsy. PCs were considered to be positive in patients with the presence of more than one hyperechoic foci in the peripheral zone with their largest diameter >3 mm. All TRUS biopsies were performed by the same physician. Results: Of 156 patients, PCs were observed in 41 patients. Between patient groups with and without concomitant PCs, there was no significant difference in PSA levels, prostate volume, and patient age. PCa frequency was 41.4% among PC-positive patients and 15.6% among PC-negative patients (p=0.001). Patients diagnosed with PCa were also categorized according to Gleason score, and PCs were observed in all the patients with Gleason score ≥8 without any exception (p<0.05). Higher Gleason scores showed positive correlation with the presence of PCs. Discussion and Conclusion: In the present study, we revealed the involvement of chronic inflammation and PCs in the pathogenesis of PCa. At the same time, we found a positive relationship between higher Gleason scores and the presence of PCs. Further high-volume prospective studies are needed to confirm this hypothesis.