Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea.
Prostate. 2012 Jan;72(1):51-7. doi: 10.1002/pros.21405. Epub 2011 Apr 25.
Currently, controversy continues regarding the association between diabetes mellitus (DM) and prostate cancer (PCa). We investigated the impact of DM in PCa detection among men who underwent contemporary multi-core prostate biopsy.
In this retrospective study, we reviewed records of 3,925 men who underwent multi (≥ 12)-core prostate biopsy at our institution. Biopsy outcomes were analyzed with respect to various variables, including DM, patient age, body mass index (BMI), prostate-specific antigen (PSA), digital rectal exam (DRE) finding, ultrasound finding, and prostate volume.
Among 3,925 subjects, 607 (15.5%) reported having DM at biopsy. Overall PCa was detected from biopsy in 1,387 (35.3%) patients, and high grade (biopsy Gleason score ≥ 7) PCa in 781 (19.9%). In multivariate analysis incorporating variables of patient age, BMI, PSA, DRE finding, ultrasound finding, and prostate volume, DM was observed to be significantly associated with higher odds of overall PCa detection via contemporary prostate biopsy (OR = 1.46, P = 0.019). When analyzed by tumor grade, DM was significantly associated with higher rate of high grade PCa detection from biopsy in multivariate analysis (OR = 1.54, P = 0.036) whereas DM and detection of low grade (biopsy Gleason score ≤ 6) PCa demonstrated no significant association (OR = 1.11, P = 0.558).
Our results showed DM was independently associated with the detection of high grade PCa via contemporary multi-core prostate biopsy. Further investigations would be needed to elucidate exact biologic basis of relationship between the two diseases.
目前，关于糖尿病（DM）与前列腺癌（PCa）之间的关联仍存在争议。我们研究了在接受当代多核心前列腺活检的男性中，DM 对 PCa 检测的影响。
在这项回顾性研究中，我们回顾了在我们机构接受多（≥12）核心前列腺活检的 3925 名男性的记录。根据 DM、患者年龄、体重指数（BMI）、前列腺特异性抗原（PSA）、直肠指检（DRE）发现、超声发现和前列腺体积等各种变量分析活检结果。
在 3925 名受试者中，607 名（15.5%）报告在活检时患有 DM。在 3925 名受试者中，607 名（15.5%）报告在活检时患有 DM。在多变量分析中，将患者年龄、BMI、PSA、DRE 发现、超声发现和前列腺体积等变量纳入分析后，DM 与通过当代前列腺活检检测到总体 PCa 的几率显著相关（OR=1.46，P=0.019）。在按肿瘤分级分析时，DM 在多变量分析中与从活检中检测到更高比例的高级别 PCa 显著相关（OR=1.54，P=0.036），而 DM 和检测到低级别（活检 Gleason 评分≤6）PCa 之间没有显著关联（OR=1.11，P=0.558）。
我们的研究结果表明，DM 与通过当代多核心前列腺活检检测到高级别 PCa 独立相关。需要进一步的研究来阐明这两种疾病之间关系的确切生物学基础。
