Flamand V, Zini L, Salleron J, Fantoni J-C, Biserte J, Villers A
Service d'urologie, hôpital Huriez, CHRU de Lille, 59037 Lille cedex, France.
Prog Urol. 2008 Jan;18(1):53-9. doi: 10.1016/j.purol.2007.12.003. Epub 2008 Mar 4.
The aim of this work is to study variations of prostate cancer incidence by stage as a function of time and place in a region of France.
Retrospective observational survey conducted in five private and public urology centres representative of the various demographic features of the Nord-Pas-de-Calais region. In each centre, the medical records of the first 25 cases of prostate cancer diagnosed in 1998, 2002 and 2004, identified from histology laboratory data, were studied by means of a case report form evaluating the circumstances of diagnosis, PSA level, grade, stage (TNM 97, classification) and initial management.
This analysis was based on 123, 124 and 125 patients in five centres in 1998, 2002 and 2004, respectively. The age at diagnosis ranged from 71.14 to 68.9 years between 1998 and 2004 (p=0.054). Median PSA decreased over this six-year period from 18 to 10.8 ng/ml. Between 1998 and 2004, the percentage of patients with localized cancer (PSA<20 ng/ml) increased from 44.8 to 66.4% (p<0.05), the percentage of patients with locally advanced cancer (PSA between 20 and 50 ng/ml) decreased from 17 to 9.6% (p<0.05), the percentage of patients with regional or distant metastatic disease (N1 and/or M1 and/or PSA>50 ng/ml) decreased from 29.4 to 22.4% (p<0.05) and the percentage of patients receiving curative treatment increased from 30 to 54.4% (p<0.005).
The prostate cancer incidence by stage varied between 1998 and 2004, with a significantly higher proportion of localized stages, which can be explained by the increased use of screening and diagnostic tests. Routine surveys can measure trends and the amplitude of incidence variations in the population of a region. A representative survey conducted in centres throughout France would allow evaluation of national trends between two publications of incidence by stage results in French registries.
本研究旨在探讨法国某地区前列腺癌发病率随时间和地点的变化情况，并分析其与疾病分期的关系。
本研究为回顾性观察性调查，在法国北部加来海峡地区具有不同人口统计学特征的五家公立和私立泌尿外科中心开展。在每个中心，从组织学实验室数据中筛选出1998年、2002年和2004年诊断的前25例前列腺癌患者的病历，通过病例报告表评估诊断情况、前列腺特异性抗原（PSA）水平、分级、分期（TNM 97分类）和初始治疗情况。
本分析分别纳入了1998年、2002年和2004年五个中心的123例、124例和125例患者。1998年至2004年间，诊断时的年龄范围为71.14岁至68.9岁（p=0.054）。在这六年期间，PSA中位数从18 ng/ml降至10.8 ng/ml。1998年至2004年间，局限性癌症（PSA<20 ng/ml）患者的比例从44.8%增至66.4%（p<0.05），局部晚期癌症（PSA在20至50 ng/ml之间）患者的比例从17%降至9.6%（p<0.05），区域或远处转移疾病（N1和/或M1和/或PSA>50 ng/ml）患者的比例从29.4%降至22.4%（p<0.05），接受根治性治疗的患者比例从30%增至54.4%（p<0.005）。
1998年至2004年间，前列腺癌发病率随分期有所变化，局限性分期的比例显著增加，这可能与筛查和诊断检测的使用增加有关。常规调查可以衡量某地区人群发病率变化的趋势和幅度。在法国各地的中心进行具有代表性的调查，将有助于评估法国登记处两次发布分期发病率结果之间的全国趋势。
