Skolarus Ted A, Wolin Kathleen Y, Grubb Robert L
Division of Urology, Department of Surgery, Washington University School of Medicine, St Louis, MO, USA.
Nat Clin Pract Urol. 2007 Nov;4(11):605-14. doi: 10.1038/ncpuro0944.
The prevalence of both obesity and prostate cancer are increasing in the US. Recently, there has been keen interest in the relationship between obesity and the biology of cancers, including prostate cancer. This article reviews the current literature regarding body mass index (BMI) and its relationship with various clinical aspects of prostate cancer, including its incidence, screening, diagnosis and treatment. Despite several biological mechanisms that potentially link obesity to prostate cancer, the effects of obesity on serum PSA levels and prostate volume, and the subsequent effects on the detection of prostate cancer, are not consistent according to the available literature. Additionally, the epidemiologic data for the incidence of prostate cancer in obese and non-obese populations are conflicting. Treatment of prostate cancer in obese populations is problematic, but data on the ability to overcome these difficulties are unclear. It is difficult to determine whether oncologic and functional outcomes in obese patients differ substantially from those in non-obese patients. Separating the contributions of technical issues from potentially different tumor biologies is not currently possible. Hopefully, the increasing focus on these two highly prevalent health problems might further elucidate their complex relationship.
在美国，肥胖症和前列腺癌的患病率都在上升。最近，人们对肥胖症与包括前列腺癌在内的癌症生物学之间的关系产生了浓厚兴趣。本文回顾了有关体重指数（BMI）及其与前列腺癌各个临床方面的关系的现有文献，包括其发病率、筛查、诊断和治疗。尽管有几种潜在的生物学机制将肥胖与前列腺癌联系起来，但根据现有文献，肥胖对血清前列腺特异抗原（PSA）水平和前列腺体积的影响，以及随后对前列腺癌检测的影响并不一致。此外，肥胖和非肥胖人群中前列腺癌发病率的流行病学数据相互矛盾。肥胖人群中前列腺癌的治疗存在问题，但关于克服这些困难能力的数据尚不清楚。很难确定肥胖患者的肿瘤学和功能结果是否与非肥胖患者有很大差异。目前还无法区分技术问题和潜在不同肿瘤生物学的影响。希望对这两个高度普遍的健康问题日益增加的关注可能会进一步阐明它们之间的复杂关系。
