Association Between Prostatic Calculi And Prostate Cancer

Objective:Prostatic calculi are commonly found during transrectal ultrasound(TRUS).The association between prostatic calculi and prostate cancer remains unclear.In this study,to investigate the relationship between the presence and characteristics of prostatic calculi and the risk of overall prostate cancer by combining the presence and characteristics of prostatic calculi recorded during TRUS guided prostate biopsy with the pathology of prostate biopsy in suspected prostate cancer patients.Furthermore,the relationship between the characteristics of prostatic calculi and the risk of prostate cancer around prostatic calculi was analyzed by pathological examination of prostate whole tissue section after radical prostatectomy.Methods:1.Retrospective analysis was performed on the data of 997 patients suspected of prostate cancer who underwent TRUS guided prostate biopsy in Northern Jiangsu People's Hospital from May 2013 to December 2019,and the patients were divided into benign group and tumor group according to the pathological results.The presence of prostatic calculi and the characteristics(location,number and size)of prostatic calculi were observed and recorded during the biopsy.Prostatic calculi were classified according to the location into the transitional zone,central zone,and peripheral zone.Prostatic calculi were classified as mild and moderate/marked according to the number and size.We defined moderate/marked prostatic calculi as multiple(?3 in number)hyperechoic foci with significant area(?3 mm in the largest diameter)and coarse shadow detected in both dimensions.Mild prostatic calculi were defined as 1 or multiple small foci without coarse shadow.Logistic regression was used to analyze the correlation between age,prostate-specific antigen(PSA),prostate volume,body mass index and prostatic calculi with overall prostate cancer and Gleason scores.2.Eighty prostate cancer patients underwent radical prostatectomy,and the prostate whole tissue section were performed to observe the pathology around prostatic calculi.According to the pathological results around prostatic calculi,the patients were divided into two groups:the benign tissues around prostatic calculi were divided into the benign group and the tumor tissues were divided into the tumor group.Logistic regression analysis was performed to analyze the correlation between clinical variables and prostate cancer around prostatic calculi.Results:1.In all the prostate biopsy patients,the age was 68.72±7.75 years,the PSA was 15.41±12.90 ng/ml,the prostate volume was 47.53±19.89 ml,the body mass index was 21.35±1.88 kg/m~2,the number of biopsy core was 19.0±4.7,and the positive rate of biopsy was 53.1%(529/997).Among the 529 prostate cancer patients,Gleason score?6 in 103 patients,7 in 145 patients,and?8 in 281 patients.The incidence of prostatic calculi was 69.3%(691/997).The characteristics of prostatic calculi in 691 patients with prostatic calculi:19.4%were distributed in the central zone,33.7%in the transitional zone,and 46.9%in the peripheral zone;Mild prostatic calculi were 37.2%and moderate/marked prostatic calculi were 62.8%.Patients in the tumor group were older,had a higher PSA,a smaller prostate,and had higher incidence of prostatic calculi than those in the benign group.Multivariate analysis showed that the presence of prostatic calculi is a risk factor for overall prostate cancer.2.In 691prostatic calculi patients,multivariate analysis based on the characteristics of different prostatic calculi showed that moderate/marked and peripheral prostatic calculi were risk factors for overall prostate cancer.3.Peripheral prostatic calculi is a risk factor for a high Gleason score(?8).4.Among the eighty patients with radical prostatectomy,the age was 67.53±4.75 years,the PSA was 24.38±9.88 ng/ml,the prostate volume was40.78±12.13 ml,the body mass index was 21.66±2.14 kg/m~2,and the incidence rate of prostatic calculi was 76.3%(61/80).The characteristics of prostatic calculi in 61patients with prostatic calculi:19.7%were distributed in the central zone,29.5%in the transitional zone,and 50.8%in the peripheral zone;Mild prostatic calculi were 37.7%and moderate/marked prostatic calculi were 62.3%.Multivariate analysis showed that moderate/marked and peripheral prostatic calculi were risk factors for prostate cancer around prostatic calculi in patients with prostate whole tissue section,but different characteristics of prostatic calculi did not increase the risk of Gleason score in the prostate cancer around prostatic calculi.Conclusion:Prostatic calculi are associated with prostate cancer to some extent,moderate/marked and peripheral prostatic calculi are risk factors for prostate cancer,but different prostatic calculi characteristics do not to affect the Gleason score of prostate cancer.