Department of Urology, Foch Hospital, Suresnes, France.
Université de Versailles-Saint-Quentin-en-Yvelines, Versailles, France.
Prostate. 2019 Oct;79(14):1640-1646. doi: 10.1002/pros.23888. Epub 2019 Aug 2.
There are no comparative data on pathological predictors at diagnosis, between African Caribbean and Caucasian men with prostate cancer (PCa), in equal-access centers. The objective of this study was to evaluate the grade groups of an African Caribbean cohort, newly diagnosed with PCa on prostate biopsy, compared with a Caucasian French Metropolitan cohort.
A retrospective, a comparative study was conducted between 2008 and 2016 between the University Hospital of Martinique in the French Caribbean West Indies, and the Saint Joseph Hospital in Paris. Clinical, biological, and pathological data were collected at diagnosis. The primary outcome was the grade groups for Gleason score; the secondary outcome was the PCa detection rate. Multivariate analysis was performed using linear regression.
Of the 1880 consecutive prostate biopsy performed in the African Caribbean cohort, 945 had a diagnosis of PCa (50.3%) and 500 of 945 in the French cohort (33.8%). African Caribbean patients were older (mean 68.5 vs 67.5 years; P = .028), had worse clinical stage (13.2% vs 5.2% cT3-4; P < .001) and higher median prostate-specific antigen (PSA) level (9.23 vs 8.32 ng/mL; P = .019). On univariate analysis, African Caribbean patients had worse pathological grade groups than French patients (P < .001). Nevertheless, after adjustment on age, stage, and PSA, there were no significant differences between the two cohorts (P = .903).
African Caribbean patients presented higher PCa detection rate, and higher grade groups at diagnosis than French patients in equal-access centers on univariate analysis but not on multivariate analysis. African Caribbean patients with equivalent clinical and biological characteristics than Caucasian patients at diagnosis might expect the same prognosis for PCa.
在同等医疗条件下，尚无关于非洲加勒比和白种人前列腺癌（PCa）患者诊断时病理预测因子的比较数据。本研究旨在评估新诊断为 PCa 的非洲加勒比队列的分级组，并与法国大都市白种人队列进行比较。
2008 年至 2016 年期间，在法属西印度群岛马提尼克岛的大学医院和巴黎的圣约瑟夫医院之间进行了回顾性、对比研究。在诊断时收集了临床、生物学和病理学数据。主要结局为格里森评分的分级组；次要结局为 PCa 检出率。采用线性回归进行多变量分析。
在非洲加勒比队列的 1880 例连续前列腺活检中，945 例诊断为 PCa（50.3%），而法国队列的 500 例中有 945 例（33.8%）。非洲加勒比患者年龄更大（平均 68.5 岁比 67.5 岁；P = .028），临床分期更差（13.2%比 5.2% cT3-4；P < .001），中位前列腺特异性抗原（PSA）水平更高（9.23 比 8.32 ng/mL；P = .019）。单因素分析显示，非洲加勒比患者的病理分级组比法国患者差（P < .001）。然而，在调整年龄、分期和 PSA 后，两组之间无显著差异（P = .903）。
在单因素分析中，与法国患者相比，在同等医疗条件下，非洲加勒比患者的 PCa 检出率更高，诊断时的分级组更高，但在多因素分析中无显著差异。在诊断时具有与白种人患者相当的临床和生物学特征的非洲加勒比患者，可能对 PCa 有相同的预后。
