Berg William T, Shapiro Edan Y, Rothberg Michael B, Bergman Ari, Scarberry Kyle, Wambi Chris, Patel Trushar, Badani Ketan K
Department of Urology, Columbia University, College of Physicians and Surgeons, New York, NY.
Department of Urology, Columbia University, College of Physicians and Surgeons, New York, NY.
Clin Genitourin Cancer. 2014 Oct;12(5):330-4. doi: 10.1016/j.clgc.2014.02.004. Epub 2014 Feb 20.
INTRODUCTION/BACKGROUND: The purpose of this study was to evaluate the prevalence of vitamin D (VitD) deficiency in men undergoing radical prostatectomy and determine whether an association exists between preoperative VitD levels and adverse pathologic features.
Patients scheduled to undergo radical prostatectomy for clinically localized disease from January to August 2012 were prospectively followed and those with available preoperative serum 25-hydroxyvitamin D levels were included. Men with a known diagnosis of VitD deficiency or taking VitD supplementation were excluded. Cox regression analysis was performed to determine whether preoperative VitD level is predictive of adverse pathologic outcomes.
One hundred consecutive men were included. Mean age was 62 (range, 42-79) years and mean VitD level was 26 (range, 6-57) ng/mL. Overall, 65 men (65%) had suboptimal levels of VitD (< 30 ng/mL), and 32 (32%) had deficiency (< 20 ng/mL). There was no significant correlation between VitD and age (P = .5). In logistic regression analysis, VitD level was not predictive of pathologic Gleason (P = .11), pathologic stage (P = .7), or positive margin status (P = .8).
The association between VitD and prostate cancer has been controversial and data suggesting an increased risk of aggressive cancer in men with low levels of VitD have been inconsistent. We found that baseline preoperative VitD level was not associated with any adverse pathologic features. However, VitD deficiency is a common finding in this population, although unrelated to patient age. These results represent the first time the correlation between VitD and prostate cancer has been evaluated in a cohort of men undergoing radical prostatectomy.
引言/背景：本研究的目的是评估接受根治性前列腺切除术的男性中维生素D（VitD）缺乏的患病率，并确定术前VitD水平与不良病理特征之间是否存在关联。
对2012年1月至8月计划因临床局限性疾病接受根治性前列腺切除术的患者进行前瞻性随访，纳入术前血清25-羟维生素D水平可用的患者。排除已知诊断为VitD缺乏或正在服用VitD补充剂的男性。进行Cox回归分析以确定术前VitD水平是否可预测不良病理结果。
纳入了连续100名男性。平均年龄为62岁（范围42 - 79岁），平均VitD水平为26 ng/mL（范围6 - 57 ng/mL）。总体而言，65名男性（65%）的VitD水平未达最佳（< 30 ng/mL），32名（32%）存在缺乏（< 20 ng/mL）。VitD与年龄之间无显著相关性（P = 0.5）。在逻辑回归分析中，VitD水平不能预测病理Gleason评分（P = 0.11）、病理分期（P = 0.7）或切缘阳性状态（P = 0.8）。
VitD与前列腺癌之间的关联一直存在争议，关于VitD水平低的男性患侵袭性癌症风险增加的数据也不一致。我们发现术前基线VitD水平与任何不良病理特征均无关联。然而，VitD缺乏在该人群中是常见现象，尽管与患者年龄无关。这些结果首次在接受根治性前列腺切除术的男性队列中评估了VitD与前列腺癌之间的相关性。
