Background: While there have been limited reports suggesting a possible association between Monoclonal Gammopathy (MG) of Undetermined Significance (MGUS) and prostate cancer, a clear biological correlation has yet to be established. Methods: In this study, we aimed to investigate the incidence of MGUS in a cohort of 168 patients undergoing TRUSBx for suspected prostate cancer between September 2022 and December 2023. Results: Our findings revealed that the incidence of MGUS, identified by serum immunofixation or abnormal free light chain ratio, was significantly higher in this cohort than the anticipated global incidence (33.93% vs. 5%). Furthermore, the prevalence of MGUS was higher in patients with a Gleason Score (GS) exceeding 7 compared to those with GS6 or with ASAP/HG PIN (34.2% vs. 28% vs. 25%, respectively). A systematic univariate analysis of 42 clinical and biological variables identified fibrinogen levels, neutrophil-to-lymphocyte ratio, and the percentage of alpha2 band in serum protein electrophoresis as significantly associated with MGUS presence. Conclusions: These findings suggest that a systemic inflammatory status and a highest GS in these patients may increase the likelihood of detecting an MGUS. To our knowledge, this study is the first to suggest an association between prostate cancer and MG. Further and larger studies are required to confirm the increased prevalence of MGUS within this target population and to establish the clinical relevance of these precocious diagnoses.
背景：尽管有少量报告提示意义未明的单克隆丙种球蛋白病（MGUS）与前列腺癌之间可能存在关联，但明确的生物学相关性尚未确立。方法：本研究旨在调查2022年9月至2023年12月期间，因疑似前列腺癌接受经直肠超声引导下前列腺穿刺活检的168例患者队列中MGUS的发病率。结果：我们的研究显示，通过血清免疫固定电泳或异常游离轻链比值检出的MGUS发病率在该队列中显著高于全球预期发病率（33.93% vs. 5%）。此外，格里森评分（GS）超过7的患者中MGUS患病率高于GS6或非典型小腺泡增生/高级别前列腺上皮内瘤变患者（分别为34.2% vs. 28% vs. 25%）。对42项临床及生物学变量的系统性单因素分析发现，纤维蛋白原水平、中性粒细胞与淋巴细胞比值以及血清蛋白电泳中α2区带百分比与MGUS存在显著相关。结论：这些发现提示，患者的全身性炎症状态及较高的格里森评分可能增加检出MGUS的可能性。据我们所知，本研究首次提示前列腺癌与单克隆丙种球蛋白病之间存在关联。需要进一步开展更大规模的研究以确认该目标人群中MGUS患病率的升高，并明确这些早期诊断的临床意义。
肿瘤(癌症)患者之家