Fox Chase Cancer Center, Department of Surgical Oncology, Philadelphia, PA 19111-2497, USA.
Nat Rev Urol. 2013 Apr;10(4):219-26. doi: 10.1038/nrurol.2013.43. Epub 2013 Mar 12.
The healthy human prostate accumulates the highest level of zinc of any soft tissue in the body. This unique property is retained in BPH, but is lost in prostatic malignancy, which implicates changes in zinc and its transporters in carcinogenesis. Indeed, zinc concentrations diminish early in the course of prostate carcinogenesis, preceding histopathological changes, and continue to decline during progression toward castration-resistant disease. Numerous studies suggest that increased zinc intake might protect against progression of prostatic malignancy. In spite of increased dietary intake, zinc accumulation might be limited by the diminished expression of zinc uptake transporters, resulting in decreased intratumoural zinc levels. This finding can explain the conflicting results of various epidemiological studies evaluating the role of zinc supplementation on primary and secondary prostate cancer prevention. Overall, more research into the mechanisms of zinc homeostasis are needed to fully understand its impact on prostate carcinogenesis. Only then can the potential of zinc and zinc transport proteins be harnessed in the diagnosis and treatment of men with prostate cancer.
健康男性的前列腺组织是人体所有软组织中含锌量最高的。这一独特特性在 BPH 中得以保留,但在前列腺恶性肿瘤中却消失了,这表明锌及其转运蛋白的变化与癌症的发生有关。事实上,锌浓度在前列腺癌发生的早期就会降低,早于组织病理学改变,并且在向去势抵抗性疾病进展的过程中继续下降。许多研究表明,增加锌的摄入可能有助于预防前列腺恶性肿瘤的进展。尽管膳食摄入增加,但锌的积累可能会受到锌摄取转运体表达减少的限制,从而导致肿瘤内锌水平降低。这一发现可以解释评估锌补充剂对原发性和继发性前列腺癌预防作用的各种流行病学研究结果相互矛盾的原因。总的来说,需要进一步研究锌动态平衡的机制,以充分了解其对前列腺癌发生的影响。只有这样,才能利用锌和锌转运蛋白的潜力,用于诊断和治疗患有前列腺癌的男性。