Thompson Ian M, Pauler Ankerst Donna, Chi Chen, Goodman Phyllis J, Tangen Catherine M, Lippman Scott M, Lucia M Scott, Parnes Howard L, Coltman Charles A
Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA.
J Clin Oncol. 2007 Jul 20;25(21):3076-81. doi: 10.1200/JCO.2006.07.6836.
Using data from men in the finasteride group of the Prostate Cancer Prevention Trial (PCPT), we evaluated the impact of prostate-specific antigen (PSA) and other risk factors on the risk of prostate cancer.
Four thousand four hundred forty men in the finasteride group of the PCPT underwent prostate biopsy, had at least one PSA and a digital rectal exam (DRE) during the year before biopsy, had at least two PSA values from the 3 years before biopsy, and were on finasteride at the time of PSA evaluation. Logistic regression was conducted using the variables age, race, family history of prostate cancer, PSA, PSA velocity, and DRE adjusting for history of prior prostate biopsy.
Six hundred forty-nine (14.6%) of 4,440 men were diagnosed with prostate cancer; 250 had Gleason 7 or higher cancer. Factors associated with an increased risk of prostate cancer included high PSA value and a rising PSA (24.9% risk for PSA value of 1.0 ng/mL and 24.8% risk for a rising PSA), family history of prostate cancer, abnormal DRE result, African American race, and older age. Factors associated with an increased risk of Gleason 7 or higher grade prostate cancer included PSA, abnormal DRE, and older age. A prior negative biopsy was associated with decreased risk of prostate cancer and high-grade prostate cancer.
Risk factors for prostate cancer on biopsy for men receiving finasteride include PSA, DRE, age, race, family history, and history of a prior negative biopsy. With the exception of the approximate reduction of PSA by half with finasteride, the impact of these risk factors is similar to men who do not receive finasteride.
利用前列腺癌预防试验（PCPT）非那雄胺组男性的数据，我们评估了前列腺特异性抗原（PSA）和其他风险因素对前列腺癌风险的影响。
PCPT非那雄胺组的4440名男性接受了前列腺活检，在活检前一年至少进行了一次PSA检测和一次直肠指检（DRE），在活检前3年至少有两个PSA值，并且在进行PSA评估时正在服用非那雄胺。使用年龄、种族、前列腺癌家族史、PSA、PSA变化率和DRE等变量进行逻辑回归分析，并对既往前列腺活检史进行校正。
4440名男性中有649名（14.6%）被诊断为前列腺癌；250名患有Gleason 7级或更高分级的癌症。与前列腺癌风险增加相关的因素包括PSA值高和PSA升高（PSA值为1.0 ng/mL时风险为24.9%，PSA升高时风险为24.8%）、前列腺癌家族史、DRE结果异常、非裔美国人种族和年龄较大。与Gleason 7级或更高分级前列腺癌风险增加相关的因素包括PSA、DRE异常和年龄较大。既往活检阴性与前列腺癌和高级别前列腺癌风险降低相关。
接受非那雄胺治疗的男性活检时前列腺癌的风险因素包括PSA、DRE、年龄、种族、家族史和既往活检阴性史。除了非那雄胺使PSA大约降低一半外，这些风险因素的影响与未接受非那雄胺治疗的男性相似。
