Herkommer K, Paiss T, Merz M, Gschwend J E, Kron M
Abteilung für Urologie, Urologische Universitätsklinik, Prittwitzstrasse 43, 89075 Ulm, Deutschland.
Urologe A. 2006 Dec;45(12):1532-9. doi: 10.1007/s00120-006-1190-8.
In a large number of studies a positive family history is documented as one of the main risk factors for the development of prostate cancer. In a US population an association between early-onset prostate cancer among familial patients and a more differentiated tumour was shown. The aim of this study was to compare clinical parameters between sporadic and familial or hereditary patients with an age at diagnosis < or =55 years.
The clinical data of prostate cancer patients with an age at diagnosis < or =55 years and who were recruited between July 1999 and the end of June 2004 to the database "familial prostate cancer in Germany" were analysed. The following data were documented for all patients: PSA at diagnosis, histopathological stage, grading, Gleason score and progression-free survival.
The clinical data of 685 patients could be completed: 222 (32.4%) had one first-degree relative with prostate cancer, 48 of whom (7.0%) were hereditary; 463 (67.6%) were sporadic. The median age at diagnosis in the hereditary patients was 51.6 (41-55) years, in the familial patients 51.1 (35-55) years and in the sporadic patients 52.0 (38-55) years. The median follow-up was 24 months in hereditary, 36 months in familial and 35 months in sporadic patients. An initial curative therapy with radical prostatectomy or radiotherapy/brachytherapy was planned in 657/685 (95.9%) of the patients. There were no clear differences regarding PSA at diagnosis, the postoperative parameters (organ-confined disease, lymph node involvement, Gleason score, grading) and the progression-free survival in sporadic and familial or hereditary patients.
Patients with an age at diagnosis < or =55 years have a positive family history more often than all prostate cancer patients in Germany. No association could be shown between pathohistological stage or clinical course and a positive family history in patients with an age at diagnosis < or =55 years.
在大量研究中，阳性家族史被记录为前列腺癌发生的主要危险因素之一。在美国人群中，家族性患者的早发性前列腺癌与肿瘤分化程度更高之间存在关联。本研究的目的是比较诊断年龄≤55岁的散发性和家族性或遗传性前列腺癌患者的临床参数。
分析了1999年7月至2004年6月底纳入“德国家族性前列腺癌”数据库的诊断年龄≤55岁的前列腺癌患者的临床资料。记录了所有患者的以下数据：诊断时的前列腺特异性抗原（PSA）、组织病理学分期、分级、 Gleason评分和无进展生存期。
685例患者的临床资料完整：222例（32.4%）有一位患前列腺癌的一级亲属，其中48例（7.0%）为遗传性；463例（67.6%）为散发性。遗传性患者的诊断中位年龄为51.6（41 - 55）岁，家族性患者为51.1（35 - 55）岁，散发性患者为52.0（38 - 55）岁。遗传性患者的中位随访时间为24个月，家族性患者为36个月，散发性患者为35个月。657/685（95.9%）的患者计划采用根治性前列腺切除术或放疗/近距离放疗进行初始根治性治疗。散发性和家族性或遗传性患者在诊断时的PSA、术后参数（器官局限性疾病、淋巴结受累、Gleason评分、分级）和无进展生存期方面没有明显差异。
诊断年龄≤55岁的患者比德国所有前列腺癌患者更常具有阳性家族史。在诊断年龄≤55岁的患者中，病理组织学分期或临床病程与阳性家族史之间未显示出关联。
