Coard Kathleen C M, Skeete Desiree H-A
Department of Pathology, The University of the West Indies, Mona, Kingston, Jamaica.
BJU Int. 2009 Jun;103(11):1482-6. doi: 10.1111/j.1464-410X.2008.08265.x. Epub 2008 Dec 8.
OBJECTIVE To document the clinicopathological characteristics of prostate cancer in a public hospital-based population in Jamaica, over a 6-year period, and examine any trends in these characteristics over time, as prostate cancer is the leading cause of cancer in Jamaican men, but there are few published reports documenting the clinicopathological profile of this disease in the Jamaican population. PATIENTS AND METHODS All patients consecutively diagnosed with prostate cancer by transrectal ultrasonography-guided biopsy at the University Hospital of the West Indies, from January 2000 to December 2005, were identified at time of diagnosis, and relevant clinical and pathological data collected from the accompanying histopathology request forms. RESULTS There were 529 cases of prostate cancer diagnosed over the 6 years. The mean (sd) age was 70.66 (8.74) years, with 137 patients aged 70-74 years. A serum prostate-specific antigen (PSA) level was obtained for 490 (92.6%) patients. Of these, an accurate PSA value was available for 456 (86.2%) patients and a 'minimum level' recorded for the remaining 34, all of whom had a PSA level of >100 ng/mL. Of the patients with available PSA information, only 91 (18.5%) had a level of < or =10.0 ng/mL. By contrast, 155 (31.6%) patients had levels of >100 ng/mL. The median (range, interquartile range) serum PSA level for those patients with accurate values was 30.7 (1-14 260, 11.7-109) ng/mL. Histologically, moderately and poorly differentiated cancers accounted for 198 (37.5%) and 160 (30.2%) cases, respectively. Correlation of the variables under investigation confirmed that there was a statistically significant positive and moderate correlation between serum PSA level and Gleason score (Spearman r 0.49; P < 0.001). Statistical analysis of all other variables, including the number of cases of prostate cancer diagnosed annually, showed no significant differences. CONCLUSION Compared with many countries, including some in the Caribbean, prostate cancer in Jamaican men is diagnosed when they are older and these patients have significantly higher PSA levels at diagnosis, suggesting more advanced disease. Despite increasing public awareness of prostate cancer, it appears that there has been no significant change in the profile of patients with prostate cancer, at the time of diagnosis, over the last 6 years, findings consistent with the absence of an organized screening programme for prostate cancer in Jamaica.
目的 记录牙买加一家公立医院6年间前列腺癌患者的临床病理特征，并研究这些特征随时间的变化趋势。前列腺癌是牙买加男性癌症的主要病因，但关于牙买加人群中该疾病临床病理特征的公开报道较少。患者与方法 对2000年1月至2005年12月在西印度大学医院经直肠超声引导下活检连续确诊为前列腺癌的所有患者，在诊断时进行识别，并从随附的组织病理学申请表中收集相关临床和病理数据。结果 6年间共诊断出529例前列腺癌病例。平均（标准差）年龄为70.66（8.74）岁，其中137例患者年龄在70 - 74岁之间。490例（92.6%）患者检测了血清前列腺特异性抗原（PSA）水平。其中，456例（86.2%）患者有准确的PSA值，其余34例记录了“最低水平”，这些患者的PSA水平均>100 ng/mL。在有PSA信息的患者中，只有91例（18.5%）的PSA水平≤10.0 ng/mL。相比之下，155例（31.6%）患者的PSA水平>100 ng/mL。有准确PSA值的患者血清PSA水平中位数（范围，四分位间距）为30.7（1 - 14260，11.7 - 109）ng/mL。组织学上，中分化和低分化癌分别占198例（37.5%）和160例（30.2%）。对所研究变量的相关性分析证实，血清PSA水平与Gleason评分之间存在统计学上显著的正相关且为中度相关（Spearman相关系数r为0.49；P < 0.001）。对所有其他变量进行统计分析，包括每年诊断的前列腺癌病例数，均未显示出显著差异。结论 与包括加勒比地区一些国家在内的许多国家相比，牙买加男性前列腺癌患者确诊时年龄更大，且诊断时PSA水平显著更高，提示疾病更晚期。尽管公众对前列腺癌的认识有所提高，但在过去6年中，前列腺癌患者诊断时的特征似乎没有显著变化，这一结果与牙买加缺乏有组织的前列腺癌筛查项目一致。
