肥胖与前列腺癌之间不确定的关系：一项义大利前列腺活检队列分析。

The uncertain relationship between obesity and prostate cancer: an Italian biopsy cohort analysis.

机构信息

Department of Urology, Ospedale Sant'Andrea, University La Sapienza, Rome, Italy.

出版信息

Eur J Surg Oncol. 2011 Dec;37(12):1025-9. doi: 10.1016/j.ejso.2011.09.036. Epub 2011 Oct 1.

DOI:10.1016/j.ejso.2011.09.036

PMID:21963050

Abstract

BACKGROUND

The study aims to investigate the relationship between obesity and prostate cancer diagnosis at biopsy.

METHODS

From 2005 onwards, a consecutive series of patients undergoing 12-core prostate biopsy for PSA value ≥ 4 ng/ml and/or positive digital rectal examination (DRE) were enrolled. Before the biopsy, patients underwent a physical examination, including height and weight measurement. Obesity was defined as body mass index (BMI) ≥30 kg/m(2). Blood samples were drawn from all patients and analyzed for total PSA and testosterone.

RESULTS

885 patients were enrolled with a median age and PSA of 67 years (range 37-95) and 6.4 ng/ml (range 1-30) respectively. Median BMI was 27.1 kg/m(2) (range 18-46.6) with 185 patients classified as obese. 363 patients had cancer at biopsy; 76 were obese. PSA was independently associated with a higher risk of cancer (OR 1.09 per 1 unit PSA, p = 0.01). On multivariate analysis, the BMI was not significantly associated with an increased prostate cancer risk (p = 0.19). Out of 363 patients with prostate cancer, 154 had a Gleason score 6 (23 were obese) and 209 a Gleason score ≥7 (53 were obese). Among men with cancer, a higher BMI on univariate (p = 0.001) and multivariate analysis (p = 0.005) was associated with high-grade disease (Gleason ≥ 7).

CONCLUSIONS

In our single center study and less aggressively screened cohort, obesity is associated with an increased risk of a high-grade Gleason score when prostate cancer is diagnosed at biopsy.

摘要

背景

本研究旨在探讨肥胖与前列腺癌活检诊断的关系。

方法

从 2005 年开始，连续系列接受 12 芯前列腺活检的患者，其 PSA 值≥4ng/ml 和/或经直肠指检（DRE）阳性。在活检前，患者进行了体格检查，包括身高和体重测量。肥胖定义为体重指数（BMI）≥30kg/m2。所有患者均抽取血样，分析总 PSA 和睾酮。

结果

共纳入 885 例患者，中位年龄和 PSA 分别为 67 岁（范围 37-95）和 6.4ng/ml（范围 1-30）。中位 BMI 为 27.1kg/m2（范围 18-46.6），其中 185 例患者为肥胖。363 例患者在活检时患有癌症；其中 76 例为肥胖。PSA 与癌症风险升高独立相关（PSA 每增加 1 单位，OR 为 1.09，p=0.01）。在多变量分析中，BMI 与前列腺癌风险增加无显著相关性（p=0.19）。在 363 例患有前列腺癌的患者中，154 例 Gleason 评分 6（23 例肥胖），209 例 Gleason 评分≥7（53 例肥胖）。在患有癌症的男性中，BMI 在单变量（p=0.001）和多变量分析（p=0.005）中更高与高级别疾病（Gleason≥7）相关。