Sion-Vardy Netta, Priel-Cohen Zvia, Mermershtain Wilmosh, Neulander Endre, Benharroch Daniel
Institute of Pathology, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Urol Oncol. 2008 Jan-Feb;26(1):31-6. doi: 10.1016/j.urolonc.2007.01.023. Epub 2007 Nov 19.
Several studies have noted ethnic differences in the natural history of prostatic carcinoma. Southern Israel has been regarded as a melting pot and, perhaps more than the rest of the country, has encouraged the ingathering of immigrants from several countries, as well as a large Bedouin community.
In an attempt to determine any differences that may exist in population groups in Israel, we have examined clinical and biologic markers in patients diagnosed with prostatic cancer in Southern Israel in 1996-2000. We wanted to demonstrate differences in the incidence and features of prostate carcinoma among the population groups in Southern Israel, and to evaluate their possible biologic significance.
Clinical parameter features, including the ethnicity origin of patients with prostatic adenocarcinoma, were reviewed in a cohort of 189 patients seen between 1996 and 2000. Tissue sections from specimens in a subset of 40 of these patients who had undergone prostatectomy were studied by immunohistochemistry for TP53, Bcl-2, and chromogranin A using the ABC peroxidase method. These markers were chosen because of their suggested impact on the biology of this tumor. Clinical correlations were examined.
We confirm the presence of ethnic differences in the features of prostatic adenocarcinoma in our geographic area. Notably, patients of North African origin were treated surgically at a younger age than immigrants from East Europe. Higher total prostate-specific antigen levels and more robust tumor cell Bcl-2 expression were detected in the East European patients. The number of Bedouin subjects in our cohort of patients with prostatic cancer was much more limited than expected. No immigrants from Ethiopia were included in our study diagnosed with prostate carcinoma during this period.
The proportion of patients of European, especially East European, origin was relatively high among the cohort of 189. Their older age and the lower proportion of subjects that underwent surgery, together with the tendency toward higher total prostate-specific antigen levels and higher Bcl-2 expression, suggest that this ethnic group may not differ significantly from the African-American group in the United States. The low representation of Bedouin and absence of Ethiopian immigrants among our patients with prostate cancer may point to a genuinely low incidence or it may be related to inadequate medical supervision in these population groups.
多项研究已注意到前列腺癌自然病史中的种族差异。以色列南部被视为一个大熔炉，或许比该国其他地区更鼓励来自多个国家的移民以及庞大的贝都因社区聚居于此。
为了确定以色列不同人群中可能存在的差异，我们对1996年至2000年在以色列南部被诊断为前列腺癌的患者的临床和生物学标志物进行了检查。我们想证明以色列南部不同人群中前列腺癌的发病率和特征差异，并评估其可能的生物学意义。
回顾了1996年至2000年间就诊的189例患者的临床参数特征，包括前列腺腺癌患者的种族来源。对其中40例行前列腺切除术患者的标本组织切片采用ABC过氧化物酶法进行免疫组织化学检测TP53、Bcl-2和嗜铬粒蛋白A。选择这些标志物是因为它们被认为对该肿瘤的生物学特性有影响。对临床相关性进行了检查。
我们证实了我们所在地理区域前列腺腺癌特征存在种族差异。值得注意的是，北非裔患者接受手术治疗的年龄比东欧移民患者年轻。东欧患者的总前列腺特异性抗原水平更高，肿瘤细胞Bcl-2表达更强。我们前列腺癌患者队列中的贝都因人数量比预期少得多。在此期间，我们的研究中没有纳入被诊断为前列腺癌的埃塞俄比亚移民。
在这189例患者队列中，欧洲裔，尤其是东欧裔患者的比例相对较高。他们年龄较大，接受手术的患者比例较低，再加上总前列腺特异性抗原水平较高和Bcl-2表达较高的趋势，表明该种族群体可能与美国的非裔美国人群体没有显著差异。我们前列腺癌患者中贝都因人的代表性较低以及埃塞俄比亚移民的缺失可能表明其发病率确实较低，或者可能与这些人群的医疗监管不足有关。
