家族史与前列腺癌及其在中国人群中的早发显著相关。
Family history is significantly associated with prostate cancer and its early onset in Chinese population.
机构信息
Department of Urology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Urology, Huashan Hospital, Fudan University, Shanghai, China.
出版信息
Prostate. 2019 Nov;79(15):1762-1766. doi: 10.1002/pros.23900. Epub 2019 Sep 9.
BACKGROUND
Family history (FH) of prostate cancer (PCa) in Chinese population is poorly understood. The objective of this study is to evaluate the association between FH and PCa in a Chinese biopsy cohort.
METHODS
Consecutive patients who received 10 to 12 core systematic prostate biopsies from April 2013 to October 2018 in three medical centers were enrolled in this study. Demographic information and clinical information were obtained through prebiopsy questionnaire, including cancer FH, age, and total prostate-specific antigen (tPSA).
RESULTS
Of 2321 patients, 83 (3.6%) were reported a FH of PCa. The positive biopsy rate in these patients was 54.2%, significantly higher than the patients without the family history of PCa (42.6%; relative risk [RR] = 1.27; P = .024). In patients with positive FH of breast cancer gene (BRCA)-related cancers (breast, ovarian, and prostate cancer, n = 154), 74 (48.1%) were diagnosed as PCa, higher than those without FH (42.7%; RR = 1.13; P = .112). Multivariate logistic regression analysis (after adjusting for age and tPSA values) showed that there was 2.1-fold increased risk of PCa in patients with positive FH of PCa (P = .005), and 1.6-fold increased risk in patients with positive FH of BRCA-related cancers (P = .019). However, there was no significant association between FH of PCa or BRCA-related cancer and high-grade PCa after adjusting age and tPSA level (P = .404 for PCa, P = 0.991 for BRCA-related cancers).
CONCLUSIONS
Patients with positive FH of PCa had 2.1-fold higher risk of PCa, and patients with positive FH of BRCA-related cancers had 1.6-fold higher risk in this biopsy cohort of Chinese population. Patients with positive FH of PCa or BRCA-related cancers would have earlier age at onset of PCa.
背景
在中国人群中，前列腺癌（PCa）的家族史（FH）了解甚少。本研究旨在评估中国前列腺活检队列中 FH 与 PCa 之间的关联。
方法
本研究纳入了 2013 年 4 月至 2018 年 10 月期间在三个医疗中心接受 10 至 12 个核心系统前列腺活检的连续患者。通过预活检问卷获得人口统计学和临床信息，包括癌症 FH、年龄和总前列腺特异性抗原（tPSA）。
结果
在 2321 名患者中，有 83 名（3.6%）报告了 PCa 的 FH。这些患者的阳性活检率为 54.2%，明显高于没有 PCa 家族史的患者（42.6%；相对风险 [RR] = 1.27；P =.024）。在有阳性 FH 的乳腺癌基因（BRCA）相关癌症（乳腺癌、卵巢癌和前列腺癌，n = 154）的患者中，有 74 名（48.1%）被诊断为 PCa，高于没有 FH 的患者（42.7%；RR = 1.13；P =.112）。多变量逻辑回归分析（调整年龄和 tPSA 值后）显示，阳性 FH 的 PCa 患者患 PCa 的风险增加 2.1 倍（P =.005），阳性 FH 的 BRCA 相关癌症患者患 PCa 的风险增加 1.6 倍（P =.019）。然而，在调整年龄和 tPSA 水平后，FH 的 PCa 或 BRCA 相关癌症与高级别 PCa 之间没有显著关联（P =.404 用于 PCa，P =.991 用于 BRCA 相关癌症）。
结论
在本中国人群前列腺活检队列中，阳性 FH 的 PCa 患者患 PCa 的风险增加 2.1 倍，阳性 FH 的 BRCA 相关癌症患者患 PCa 的风险增加 1.6 倍。阳性 FH 的 PCa 或 BRCA 相关癌症患者的 PCa 发病年龄更早。
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