Department of Tumor Biology, Institute of Cancer Research, Oslo University Hospital, Radiumhospitalet, Oslo, Norway.
Prostate. 2013 Feb 15;73(3):250-60. doi: 10.1002/pros.22564. Epub 2012 Jul 20.
Experimental evidence suggests a role for the β(2) -adrenergic receptor pathway in prostate cancer (PCa). We have investigated the association of β-blocker use with PCa incidence and survival in a Norwegian cohort.
Data from the Oslo II study in 2000 (n = 6515) were linked with information from the Cancer Registry of Norway and Statistics Norway. PCa risk and overall- and PCa-specific mortality were analyzed using uni- and multi-variable Cox- and competing risk regression models.
At baseline, 776 men (11.9%) reported using a β-blocker. 212 men (3.3%) were diagnosed with PCa before the survey, leaving 6,303 eligible for incidence analysis. During a median follow-up of 122 months, 448 (7.1%) men were diagnosed with PCa. β-blocker use was not associated with PCa risk [hazard ratio (HR): 1.05, 95% CI: 0.79-1.40]. For all patients (n = 655; including med diagnosed before the survey), β-blocker use was not associated with PCa-specific mortality (HR: 0.55, 95% CI 0.24-1.26, P = 0.16). However, in the subgroup of men planned to receive androgen deprivation therapy (ADT), as reported to the Cancer Registry (n = 263), β-blocker use was associated with reduced PCa-specific mortality (HR: 0.14, 95% CI 0.02-0.85, P = 0.032). No effect on overall mortality was seen (HR, all patients: 0.88, 95% CI 0.56-1.38, P = 0.57). β-blocker use did not appear to affect PSA level, Gleason score, or T-stage at diagnosis; however, these variables were missing for many cases.
Our findings demonstrate a possible benefit of β-blocker use for men treated with ADT, suggesting the need for investigation in larger cohorts.
实验证据表明β（2）-肾上腺素能受体途径在前列腺癌（PCa）中起作用。我们研究了β受体阻滞剂的使用与挪威队列中 PCa 发病率和生存率的关系。
2000 年奥斯陆 II 研究的数据（n=6515）与挪威癌症登记处和挪威统计局的信息相链接。使用单变量和多变量 Cox 风险回归模型和竞争风险回归模型分析 PCa 风险以及总死亡率和 PCa 特异性死亡率。
在基线时，776 名男性（11.9%）报告使用了β受体阻滞剂。212 名男性（3.3%）在调查前被诊断为 PCa，其余 6303 名男性符合发病率分析的条件。在中位随访 122 个月期间，448 名男性（7.1%）被诊断为 PCa。β受体阻滞剂的使用与 PCa 风险无关[风险比（HR）：1.05，95%置信区间（CI）：0.79-1.40]。对于所有患者（n=655，包括在调查前被诊断为 PCa 的患者），β受体阻滞剂的使用与 PCa 特异性死亡率无关（HR：0.55，95%CI 0.24-1.26，P=0.16）。然而，在向癌症登记处报告的计划接受雄激素剥夺治疗（ADT）的男性亚组中（n=263），β受体阻滞剂的使用与降低 PCa 特异性死亡率相关（HR：0.14，95%CI 0.02-0.85，P=0.032）。未观察到对总死亡率的影响（所有患者的 HR：0.88，95%CI 0.56-1.38，P=0.57）。β受体阻滞剂的使用似乎并未影响 PSA 水平、Gleason 评分或诊断时的 T 分期；然而，许多情况下这些变量都缺失。
我们的研究结果表明，β受体阻滞剂的使用可能对接受 ADT 治疗的男性有益，这表明需要在更大的队列中进行研究。
