Department of Urology, Aerospace Medical Center, Cheongwon-Gun, Choongchungbuk-Do, Korea.
BJU Int. 2014 Dec;114(6):891-5. doi: 10.1111/bju.12600. Epub 2014 Oct 20.
To evaluate the impact of obesity on prostate cancer detection, as measured by the body mass index (BMI) in a Korean biopsy population.
We retrospectively reviewed the records of 1213 men who underwent transrectal ultrasonography-guided prostate biopsy at our institution. Biopsy outcomes were analysed with respect to various variables, including patient age, prostate-specific antigen (PSA), prostate volume, digital rectal examination (DRE) findings and obesity, defined as BMI ≥25 kg/m(2) , an Asian BMI category.
Among 1213 men, 408 (33.6%) were obese and 344 (28.4%) had a positive biopsy. Obese men were younger (65.5 vs 67.1 years, P = 0.003), had a larger prostate (49.2 vs 42.9 mL, P < 0.001) and were less likely to have any abnormality on DRE (8.1 vs 15.9% P < 0.001) than non-obese men. In the multivariate analysis, obesity was significantly associated with a higher risk of prostate cancer detection in men undergoing biopsy (odds ratio [OR] = 1.446, P = 0.024). In addition, obesity was significantly associated with a higher rate of biopsy-detected high grade (Gleason score ≥4 + 3) disease, and this association remained after multivariate adjustment (OR = 1.498, P = 0.039).
Obese men were younger, had a larger prostate, and had less tendency to have an abnormality on DRE than non-obese men. Obesity was associated with a higher risk of prostate cancer detection as an independent factor, including high grade prostate cancer in a Korean biopsy population.
评估肥胖(以亚洲人 BMI 分类中 BMI≥25kg/m²定义)对韩国经直肠超声引导前列腺穿刺活检人群中前列腺癌检出的影响。
我们回顾性分析了在我院接受经直肠超声引导前列腺穿刺活检的 1213 名男性患者的病历。分析了包括患者年龄、前列腺特异性抗原(PSA)、前列腺体积、直肠指诊(DRE)结果和肥胖等变量与前列腺活检结果的相关性。
在 1213 名男性中,408 名(33.6%)肥胖,344 名(28.4%)活检阳性。肥胖患者更年轻(65.5 岁 vs 67.1 岁,P=0.003),前列腺体积更大(49.2 毫升 vs 42.9 毫升,P<0.001),DRE 异常的可能性更小(8.1% vs 15.9%,P<0.001)。多变量分析显示,肥胖与活检患者前列腺癌检出风险增加显著相关(优势比[OR] = 1.446,P=0.024)。此外,肥胖与活检检出高级别(Gleason 评分≥4+3)疾病的比例显著升高相关,这种相关性在多变量调整后仍然存在(OR=1.498,P=0.039)。
与非肥胖患者相比,肥胖患者更年轻,前列腺体积更大,DRE 异常的可能性更小。肥胖是独立的前列腺癌检出危险因素,包括在韩国活检人群中与高级别前列腺癌相关。