Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.
Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.
Br J Cancer. 2019 Feb;120(4):466-471. doi: 10.1038/s41416-019-0380-2. Epub 2019 Jan 25.
High diet quality may support a metabolic and anti-inflammatory state less conducive to tumour progression. We prospectively investigated diet quality in relation to Gleason grade progression among localised prostate cancer patients on active surveillance, a clinical management strategy of disease monitoring and delayed intervention.
Men with newly diagnosed Gleason score 6 or 7 prostate cancer enroled on a biennial monitoring regimen. Patients completed a food frequency questionnaire (FFQ) at baseline (n = 411) and first 6-month follow-up (n = 263). Cox proportional hazards models were fitted to evaluate multivariable-adjusted associations of diet quality [defined via the Healthy Eating Index (HEI)-2015] with Gleason grade progression.
After a median follow-up of 36 months, 76 men progressed. Following adjustment for clinicopathologic factors, we observed a suggestive inverse association between baseline diet quality and Gleason grade progression [hazard ratio (HR) and 95% confidence interval (CI) for the highest vs. the lowest HEI-2015 tertile: 0.59 (0.32-1.08); P = 0.06]. We observed no associations with diet quality at 6-month follow-up, nor change in diet quality from baseline.
In localised prostate cancer patients on surveillance, higher diet quality or conformance with United States dietary guidelines at enrolment may lower risk of Gleason grade progression, though additional confirmatory research is needed.
高饮食质量可能支持代谢和抗炎状态，不利于肿瘤进展。我们前瞻性研究了饮食质量与局部前列腺癌患者在主动监测中的 Gleason 分级进展之间的关系，主动监测是一种疾病监测和延迟干预的临床管理策略。
新诊断为 Gleason 评分 6 或 7 的前列腺癌患者入组，每年监测两次。患者在基线（n=411）和第一次 6 个月随访（n=263）时完成了食物频率问卷（FFQ）。使用 Cox 比例风险模型评估饮食质量（通过健康饮食指数[HEI]-2015 定义）与 Gleason 分级进展的多变量调整关联。
中位随访 36 个月后，76 名男性出现进展。在校正临床病理因素后，我们观察到基线饮食质量与 Gleason 分级进展之间存在提示性负相关[最高与最低 HEI-2015 三分位组的风险比（HR）和 95%置信区间（CI）：0.59（0.32-1.08）；P=0.06]。我们未观察到 6 个月随访时饮食质量与随访期间饮食质量变化与 Gleason 分级进展之间的关联。
在接受监测的局部前列腺癌患者中，较高的饮食质量或符合美国饮食指南可能降低 Gleason 分级进展的风险，但需要更多的确认性研究。
