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白人前列腺癌患者与非洲裔前列腺癌患者的活检核心长度。

Biopsy core length in white versus African descendant prostate cancer patients.

机构信息

UroScience, Department of Urology, State University of Campinas, Unicamp and Pontifical Catholic University of Campinas, PUC-Campinas, Campinas, SP, Brazil.

出版信息

Scand J Urol. 2020 Jun;54(3):188-193. doi: 10.1080/21681805.2020.1754907. Epub 2020 Apr 28.

Abstract

To explore whether distinct prostate cancer (PCa) prognoses between ethnicities could be explained by diverse characteristics in the prostate biopsy. Clinical, prostate biopsy and surgical single-institution data of whites and African descendants with similar access to the health system who underwent radical prostatectomy whole gland histopathology within 60 days after biopsy from 2010 to 2011 and followed for 5 years minimum were compared. Among 203 included patients, 153 (75.4%) were whites and 50 (24.6%) were African descendants. The mean patients' age was 63.7 (± 6.8) years. Digital rectal examination (DRE) was suspected of cancer in 45.2% of the patients. The prostate biopsy core length was smaller in African descendants than in whites, overall 11.0 ± 3.2 vs 12.0 ± 2.9 mm,  = 0.037, and without neoplasia, 10.4 ± 3.8 vs 11.7 ± 3.1 mm,  = 0.038, respectively. Also, suspicious DRE showed smaller biopsy core length, overall 11.1 ± 3.2 mm vs 12.4 ± 2.6,  = 0.003, cancer positive 12.0 ± 4.8 mm vs 13.3 ± 3.7,  = 0.022 and negative 10.6 ± 3.6 mm vs 12.2 ± 3.0,  = 0.002. On 81 months median follow-up, more African descendants were lost to follow-up (10%,  = 5 vs 3.9%,  = 6) and the biochemical recurrence rate was the same between the groups (33.3%). In a PCa population with similar access to the health system, prostate biopsy core length in African descendant men is significantly smaller than in whites. This finding is new and may add to the controversial argument of PCa having a worse prognosis in African descendant patients.

摘要

为了探究不同种族之间是否存在不同的前列腺癌(PCa)预后,我们对白人患者和非洲裔患者的前列腺活检特征进行了研究。该研究纳入了 2010 年至 2011 年间在活检后 60 天内接受全前列腺组织学根治性前列腺切除术的白人患者和非洲裔患者,所有患者都有相似的机会进入医疗系统接受治疗。这些患者的临床、前列腺活检和手术数据都来自于单机构。研究人员对这些患者进行了至少 5 年的随访。在 203 名纳入的患者中,153 名(75.4%)为白人,50 名(24.6%)为非洲裔。患者的平均年龄为 63.7(±6.8)岁。45.2%的患者直肠指检(DRE)怀疑患有癌症。非洲裔患者的前列腺活检核心长度明显小于白人患者,分别为 11.0±3.2mm 和 12.0±2.9mm(=0.037),无肿瘤患者的活检核心长度也分别为 10.4±3.8mm 和 11.7±3.1mm(=0.038)。此外,DRE 结果可疑的患者的活检核心长度也较小,分别为 11.1±3.2mm 和 12.4±2.6mm(=0.003)、12.0±4.8mm 和 13.3±3.7mm(=0.022)、10.6±3.6mm 和 12.2±3.0mm(=0.002)。在中位随访时间为 81 个月时,更多的非洲裔患者失访(10%,=5 与 3.9%,=6),两组的生化复发率相同(33.3%)。在具有相似医疗保健系统获取机会的 PCa 人群中,非洲裔男性的前列腺活检核心长度明显小于白人。这一发现是新的,可能加剧了有关非洲裔患者 PCa 预后更差的争议。

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