Zuccolo Luisa, Harris Ross, Gunnell David, Oliver Steven, Lane Jane Athene, Davis Michael, Donovan Jenny, Neal David, Hamdy Freddie, Beynon Rebecca, Savovic Jelena, Martin Richard Michael
Department of Social Medicine, University of Bristol, Bristol, United Kingdom.
Cancer Epidemiol Biomarkers Prev. 2008 Sep;17(9):2325-36. doi: 10.1158/1055-9965.EPI-08-0342.
Height, a marker of childhood environmental exposures, is positively associated with prostate cancer risk, perhaps through the insulin-like growth factor system. We investigated the relationship of prostate cancer with height and its components (leg and trunk length) in a nested case-control study and with height in a dose-response meta-analysis.
We nested a case-control study within a population-based randomized controlled trial evaluating treatments for localized prostate cancer in British men ages 50 to 69 years, including 1,357 cases detected through prostate-specific antigen testing and 7,990 controls (matched on age, general practice, assessment date). Nine bibliographic databases were searched systematically for studies on the height-prostate cancer association that were pooled in a meta-analysis.
Based on the nested case-control, the odds ratio (OR) of prostate-specific antigen-detected prostate cancer per 10 cm increase in height was 1.06 [95% confidence interval (95% CI): 0.97-1.16; p(trend) = 0.2]. There was stronger evidence of an association of height with high-grade prostate cancer (OR: 1.23; 95% CI: 1.06-1.43), mainly due to the leg component, but not with low-grade disease (OR: 0.99; 95% CI: 0.90-1.10). In general, associations with leg or trunk length were similar. A meta-analysis of 58 studies found evidence that height is positively associated with prostate cancer (random-effects OR per 10 cm: 1.06; 95% CI: 1.03-1.09), with a stronger effect for prospective studies of more advanced/aggressive cancers (random-effects OR: 1.12; 95% CI: 1.05-1.19).
These data indicate a limited role for childhood environmental exposures-as indexed by adult height-on prostate cancer incidence, while suggesting a greater role for progression, through mechanisms requiring further investigation.
身高是儿童期环境暴露的一个指标,与前列腺癌风险呈正相关,可能是通过胰岛素样生长因子系统。我们在一项巢式病例对照研究中调查了前列腺癌与身高及其组成部分(腿长和躯干长度)之间的关系,并在一项剂量反应荟萃分析中研究了前列腺癌与身高的关系。
我们在一项基于人群的随机对照试验中进行了一项巢式病例对照研究,该试验评估了50至69岁英国男性局限性前列腺癌的治疗方法,包括通过前列腺特异性抗原检测发现的1357例病例和7990例对照(按年龄、全科医疗、评估日期匹配)。我们系统检索了九个文献数据库,以查找有关身高与前列腺癌关联的研究,并将其纳入荟萃分析。
基于巢式病例对照研究,身高每增加10厘米,前列腺特异性抗原检测出的前列腺癌的优势比(OR)为1.06 [95%置信区间(95%CI):0.97 - 1.16;p(趋势)= 0.2]。有更强的证据表明身高与高级别前列腺癌有关联(OR:1.23;95%CI:1.06 - 1.43),主要是由于腿部组成部分,但与低级别疾病无关(OR:0.99;95%CI:0.90 - 1.10)。总体而言,与腿长或躯干长度的关联相似。对58项研究的荟萃分析发现,有证据表明身高与前列腺癌呈正相关(每10厘米的随机效应OR:1.06;95%CI:1.03 - 1.09),对于更晚期/侵袭性癌症的前瞻性研究,效应更强(随机效应OR:1.12;95%CI:1.05 - 1.19)。
这些数据表明,以成人身高为指标的儿童期环境暴露在前列腺癌发病中作用有限,同时提示通过需要进一步研究的机制,其在疾病进展中作用更大。