Wayne State University School of Medicine and Karmanos Cancer Institute, Detroit, Michigan, USA.
J Urol. 2010 May;183(5):1792-6. doi: 10.1016/j.juro.2010.01.015. Epub 2010 Mar 17.
The incidence of prostate cancer is approximately 60% higher and the mortality rate is 2 to 3 times greater in black than in white American men. We propose that a more rapid prostate cancer growth rate and/or earlier transformation from latent to aggressive prostate cancer in black than in white men contribute to this disparity.
We evaluated entirely embedded prostate glands on autopsy from 1,056 black and white men who died of causes other than prostate cancer. We also reviewed data from our radical prostatectomy database and from the Detroit Surveillance, Epidemiology and End Results database.
Autopsy data indicated that subclinical prostate cancer in black and white men starts at early age and clinical characteristics do not differ by race at early ages. Radical prostatectomy specimen data revealed that prostate cancer volume and Gleason grade were greater in black than in white men. Advanced or metastatic prostate cancer occurred at a 4:1 ratio in black and white men, respectively, in the Detroit Surveillance, Epidemiology and End Results registry database.
Results showed that age at prostate cancer initiation and clinical characteristics did not differ by race in our autopsy series, prostate cancer volume after radical prostatectomy was greater in black than in white men and disease became distant disease at a ratio of 4 black men to 1 white man in the Detroit Surveillance, Epidemiology and End Results population. These findings support the concept that prostate cancer grows more rapidly in black than in white men and/or earlier transformation from latent to aggressive prostate cancer occurs in black than in white men.
黑人美国男性患前列腺癌的发病率比白人男性高约 60%，死亡率高 2 至 3 倍。我们认为，黑人男性的前列腺癌生长速度比白人男性更快，或者从潜伏性前列腺癌向侵袭性前列腺癌的转化更早，导致了这种差异。
我们评估了 1056 名因非前列腺癌原因死亡的黑人和白人男性的完全嵌入式前列腺组织。我们还回顾了我们的根治性前列腺切除术数据库和底特律监测、流行病学和结果数据库的数据。
尸检数据表明，黑人和白人男性的亚临床前列腺癌起始于早期，且在早期种族之间的临床特征没有差异。根治性前列腺切除术标本数据显示，黑人男性的前列腺癌体积和 Gleason 分级大于白人男性。在底特律监测、流行病学和结果登记数据库中，黑人男性和白人男性分别以 4:1 的比例发生晚期或转移性前列腺癌。
结果表明，在我们的尸检系列中，前列腺癌起始年龄和临床特征不因种族而不同，根治性前列腺切除术后前列腺癌体积在黑人男性中大于白人男性，在底特律监测、流行病学和结果人群中，黑人男性发生远处疾病的比例为 4 比 1。这些发现支持这样一种观点，即黑人男性的前列腺癌生长速度比白人男性更快，或者从潜伏性前列腺癌向侵袭性前列腺癌的转化更早发生在黑人男性中。
