Abstract
Introduction: This study aimed to investigate the relationship between the International Society of Urological Pathology (ISUP) score upgrade and inflammation in transrectal ultrasound-guided prostate biopsy (TRUS-Bx) specimens. Methods: The data of 340 patients who underwent robot-assisted radical prostatectomy were retrospectively evaluated, and two groups were formed based on the presence (Group 1, n=168) or absence (Group 2, n=172) of an ISUP score upgrade. Prostate characteristics, imaging findings, and inflammation on TRUS-Bx were recorded in both groups for statistical analysis. Univariate and multivariate analyses were used to identify factors predicting the development of the upgrade. Results: Total inflammation was significantly greater in Group 1 compared to Group 2 (p=0.04). Glandular-located inflammation was significantly higher in Group 2 compared to Group 1 (p=0.001). When the factors predicting ISUP score upgrade were examined, glandular inflammation was found to be significant in univariate analysis (p=0.001), while seminal vesicle invasion in multiparametric magnetic resonance imaging and ISUP grade in TRUS-Bx were found to be significant predictors in multivariate analysis (p=0.022, p=0.009, respectively). Conclusion: Prostatitis accompanying prostate cancer is observed more frequently in patients with an ISUP score upgrade. The location of inflammation may offer insights into predicting an upgrade.