Potti Anil, Panwalkar Amit W, Langness Eric
Department of Medicine, University of North Dakota School of Medicine, Fargo, ND 58102, USA.
J Carcinog. 2003 Jul 15;2(1):4. doi: 10.1186/1477-3163-2-4.
Evidence implicating pesticides as causative agents of prostate cancer is controversial, and specifically, data in young adults is lacking. Hence, we performed a preliminary study evaluating the relationship between pesticide exposure and prostate cancer in young males. After approval from the University of North Dakota Institutional Review Board and Human Subjects Committee, a retrospective study was performed on all young males (</ = 50 years) with a biopsy-proven diagnosis of carcinoma of the prostate. The records of all patients aged less than/equal to 50 years, with a diagnosis of adenocarcinoma of the prostate, from January 1991 through December 2001 were reviewed. Pesticide risk assessment interviews were performed by a single member of the team, for consistency, via telephone on the basis of a pre-determined questionnaire investigating occupations and hobbies with special emphasis on: Duration of exposure. An exposure index was calculated for each interviewed subject according to the following formula: hours/day x days/year x years. Patients with an exposure index >2400 hours were considered as 'exposed.' The 2400 hour cut-off value was chosen on the basis of previous reports indicating that this figure represents heavy exposure to genotoxic agents. Statistical analysis was obtained using SPSS-10ledR;. Between 1991 and 2001, 61 young males with adenocarcinoma of the prostate were identified, of whom 56 patients with a mean age of 47 years (range: 40-49) had complete records of treatment and could be contacted for completion of the questionnaire. The most common stage at presentation was Stage III and the mean Gleason's score was 7.5 (range 5-9). Interestingly, almost a third (16/56, 28.6%) of patients had stage IV disease at presentation. 37/56 (66.1%) patients had 'significant' exposure in our study. In addition, interestingly, the mean survival in the subgroup of patients with pesticide exposure was 11.3 months (SD: +/- 2.3 months), while the mean survival in the patients without pesticide exposure (n = 19) was 20.1 months (SD: +/- 3.1 months), with p-value <0.01. Although our study is relatively small, it does reveal preliminary evidence linking pesticide exposure to the early development of, possibly aggressive, prostate adenocarcinoma. Future, larger, epidemiological studies are needed to confirm the findings of our study.
有证据表明农药是前列腺癌的致病因素,这一观点存在争议,特别是在年轻人中缺乏相关数据。因此,我们进行了一项初步研究,评估年轻男性中农药暴露与前列腺癌之间的关系。在获得北达科他大学机构审查委员会和人类受试者委员会的批准后,对所有经活检证实患有前列腺癌的年轻男性(≤50岁)进行了一项回顾性研究。回顾了1991年1月至2001年12月期间所有年龄小于或等于50岁、诊断为前列腺腺癌的患者记录。为确保一致性,由团队中的一名成员根据预先确定的问卷通过电话进行农药风险评估访谈,问卷重点调查职业和爱好,特别关注:暴露持续时间。根据以下公式为每位受访对象计算暴露指数:小时/天天�天×天/年×年数。暴露指数>2400小时的患者被视为“暴露”。选择2400小时的临界值是基于先前的报告,该报告表明这个数字代表了对基因毒性物质的重度暴露。使用SPSS-10进行统计分析。1991年至2001年期间,共识别出61名患有前列腺腺癌的年轻男性,其中56名平均年龄为47岁(范围:40-49岁)的患者有完整的治疗记录,并且可以联系他们以完成问卷。就诊时最常见的分期是III期,平均 Gleason 评分为7.5(范围5-9)。有趣的是,几乎三分之一(16/56,28.6%)的患者就诊时患有IV期疾病。在我们的研究中,37/56(66.1%)的患者有“显著”暴露。此外,有趣的是,农药暴露患者亚组的平均生存期为11.3个月(标准差:±2.3个月),而未接触农药的患者(n = 19)的平均生存期为20.1个月(标准差:±3.1个月),p值<0.01。尽管我们的研究规模相对较小,但它确实揭示了初步证据,表明农药暴露与可能具有侵袭性的前列腺腺癌的早期发展有关。未来需要更大规模的流行病学研究来证实我们的研究结果。