Schnoeller Thomas J, Jentzmik Florian, Schrader Andres J, Steinestel Julie
Department of Urology, Ulm University Medical Center, Ulm, Germany.
Department of Urology, St. Elisabeth Hospital, Ravensburg, Germany.
Oncotarget. 2017 Jul 18;8(29):47110-47120. doi: 10.18632/oncotarget.16943.
Both cholesterol levels and the use of statins have been described to influence the development and prognosis of prostate cancer (PC). In this retrospective, cross-sectional analysis of consecutive cases from a tertiary referral center we evaluated an association between hypercholesterolemia (≥5.0mmol/l), the use of statins, and advanced/aggressive PC in 767 men with histologically confirmed, clinically localized PC awaiting radical prostatectomy. We found that patients with HCE (n=287, 37.4%) had a significantly higher incidence of poorly differentiated PC (Gleason score ≥7b, 81.1% vs. 4.9%), advanced local tumor stage (≥pT3, 57.7% vs. 22.2%), and nodal involvement (19.8% vs. 1.6%). Multivariate logistic regression analysis identified hypercholesterolemia as a risk factor for aggressive and/or advanced PC (OR 2.01, p<0.001) whereas statin intake showed an odds ratio of 0.49 (p=0.005) indicating a negative association with high-risk PC. Despite a limited number of patients using statins (~9.5%), adjusted and weighed multivariate logistic regression models revealed that preoperative hypercholesterolemia is associated with a diagnosis of high-risk PC which is negatively influenced by statin intake.
胆固醇水平和他汀类药物的使用均已被描述为会影响前列腺癌（PC）的发生发展及预后。在这项对一家三级转诊中心连续病例进行的回顾性横断面分析中，我们评估了767例组织学确诊、临床局限性前列腺癌且等待根治性前列腺切除术的男性患者中，高胆固醇血症（≥5.0mmol/l）、他汀类药物的使用与晚期/侵袭性前列腺癌之间的关联。我们发现，高胆固醇血症患者（n = 287，37.4%）中低分化前列腺癌（Gleason评分≥7b，81.1%对4.9%）、局部肿瘤晚期（≥pT3，57.7%对22.2%）及淋巴结受累（19.8%对1.6%）的发生率显著更高。多因素逻辑回归分析确定高胆固醇血症是侵袭性和/或晚期前列腺癌的一个危险因素（比值比2.01，p < 0.001），而他汀类药物摄入的比值比为0.49（p = 0.005），表明与高危前列腺癌呈负相关。尽管使用他汀类药物的患者数量有限（约9.5%），但经调整和加权的多因素逻辑回归模型显示，术前高胆固醇血症与高危前列腺癌的诊断相关，而他汀类药物摄入对其有负面影响。
