Supplementary Material for: Sexually Transmitted Infections in Prostate Cancer: A Prospective Multicenter Analysis

Objective: Chronic inflammation and infections have been implicated in prostate cancer (PCa) pathogenesis. The association between sexually transmitted infections (STIs) and PCa remains inconclusive. The objective was to evaluate the presence of STI-related pathogens in patients with PCa compared to a control group.
Methods: A prospective multicenter study involving 239 male patients with a clinical suspicion of PCa was conducted. Among the participants, 176 had histologically confirmed PCa, while 63 served as controls with benign histology. Urine, glans swabs, and prostate biopsy specimens were collected from each participant and analyzed using polymerase chain reaction (PCR) to detect a broad panel of STI-causing pathogens, including Candida spp., Chlamydia trachomatis, Mycoplasma genitalium, Neisseria gonorrhoeae, Trichomonas vaginalis, herpes simplex virus types 1 and 2, and human papillomavirus.
Results: A total of 717 samples were processed. The detection frequency of STI-related pathogens was relatively low across all sample types. Mycoplasma genitalium was the most frequently detected pathogen, particularly in prostate biopsy samples. No statistically significant association was found between the presence of these pathogens and the incidence of PCa. Neisseria gonorrhoeae and Candida spp. were not detected in any of the samples.
Conclusion: This study did not find a statistically significant association between the presence of STIs and PCa. The low prevalence of STI pathogens despite the use of highly sensitive PCR methods suggests that these infections may play a limited role in prostate carcinogenesis. Future research should consider focusing on the role of the urinary and prostatic microbiome in chronic prostatic inflammation.

研究目的：慢性炎症与感染已被证实与前列腺癌（prostate cancer, PCa）的发病机制相关。目前性传播感染（sexually transmitted infections, STIs）与前列腺癌之间的关联仍不明确。本研究旨在对比前列腺癌患者与对照组人群中，性传播感染相关病原体的检出情况。
研究方法：本研究为一项前瞻性多中心研究，共纳入239例临床疑似前列腺癌的男性患者。其中176例经组织学确诊为前列腺癌，剩余63例为良性组织学表现的对照组受试者。采集所有受试者的尿液、龟头拭子及前列腺活检标本，采用聚合酶链反应（polymerase chain reaction, PCR）检测广谱性传播致病病原体，包括念珠菌属（Candida spp.）、沙眼衣原体（Chlamydia trachomatis）、生殖支原体（Mycoplasma genitalium）、淋病奈瑟菌（Neisseria gonorrhoeae）、阴道毛滴虫（Trichomonas vaginalis）、单纯疱疹病毒1型及2型，以及人乳头瘤病毒（human papillomavirus）。
研究结果：本研究共处理717份标本。所有标本类型中的性传播感染相关病原体检出率均相对较低。生殖支原体是最常被检出的病原体，尤其在前列腺活检标本中。未发现此类病原体的检出与前列腺癌发病存在统计学显著关联。所有标本中均未检出淋病奈瑟菌与念珠菌属。
研究结论：本研究未发现性传播感染的存在与前列腺癌之间存在统计学显著关联。尽管采用了高灵敏度的聚合酶链反应检测方法，性传播感染病原体的检出率仍较低，提示此类感染在前列腺癌变过程中可能仅发挥有限作用。未来的研究可考虑聚焦于尿液与前列腺微生物组在慢性前列腺炎中的作用。