Venkitaraman Ramachandran, Thomas Karen, Grace Phillip, Dearnaley David P, Horwich Alan, Huddart Robert A, Parker Christopher C
Department of Clinical Oncology, Ipswich Hospital NHS Trust, Ipswich, Suffolk, UK.
Tumour Biol. 2010 Apr;31(2):97-102. doi: 10.1007/s13277-009-0013-0. Epub 2010 Feb 16.
The aim of this study was to determine whether serum concentrations of micronutrients, antioxidants and vitamins predict rate of disease progression in untreated, localised prostate cancer. Patients with localised prostatic adenocarcinoma on a prospective study of active surveillance underwent monitoring with serial PSA levels and repeat prostate biopsies. Disease progression was defined as either adverse histology on repeat biopsy (primary Gleason grade >or=4 or >50% positive cores of total) or radical treatment for PSA velocity >1 ng ml(-1) year(-1). Time to disease progression was analysed with respect to baseline levels of alpha-tocopherol, gamma-tocopherol, alpha-carotene and beta-carotene, lycopene, retinol and selenium. One hundred four patients were evaluable, with a median follow-up of 2.5 years. Thirty-eight patients experienced disease progression, 13 biochemical and 25 histologic progression. Median time to disease progression was 2.62 years. No significant association was seen between time to disease progression and baseline serum levels of alpha-tocopherol (p = 0.86), gamma-tocopherol (p = 0.84), alpha-carotenoid (p = 0.66), beta-carotene (p = 0.65), lycopene (p = 0.0.15), retinol (p = 0.76) or selenium (p = 0.76). No significant association was seen between serum levels of the micronutrients, antioxidants or vitamins and either adverse histology on repeat biopsy or PSA velocity. Our data do not support the hypothesis that high serum concentrations of micronutrients, antioxidants and vitamins prevent disease progression in men with localised prostate cancer.
本研究的目的是确定血清中微量营养素、抗氧化剂和维生素的浓度是否能预测未经治疗的局限性前列腺癌的疾病进展速度。对局限性前列腺腺癌患者进行前瞻性主动监测研究，通过连续的前列腺特异性抗原（PSA）水平监测和重复前列腺活检进行监测。疾病进展定义为重复活检时出现不良组织学结果（原发性Gleason分级≥4或阳性核心占总核心数的>50%）或因PSA速度>1 ng/ml/年而进行根治性治疗。分析疾病进展时间与基线水平的α-生育酚、γ-生育酚、α-胡萝卜素、β-胡萝卜素、番茄红素、视黄醇和硒之间的关系。104例患者可进行评估，中位随访时间为2.5年。38例患者出现疾病进展，13例为生化进展，25例为组织学进展。疾病进展的中位时间为2.62年。疾病进展时间与基线血清α-生育酚水平（p = 0.86）、γ-生育酚水平（p = 0.84）、α-类胡萝卜素水平（p = 0.66）、β-胡萝卜素水平（p = 0.65）、番茄红素水平（p = 0.15）、视黄醇水平（p = 0.76）或硒水平（p = 0.76）之间均未发现显著关联。微量营养素、抗氧化剂或维生素的血清水平与重复活检时的不良组织学结果或PSA速度之间也未发现显著关联。我们的数据不支持高血清浓度的微量营养素、抗氧化剂和维生素可预防局限性前列腺癌男性疾病进展这一假设。
