Division of Epidemiology & Biostatistics, School of Public Health, San Diego State University, San Diego, CA 92182, USA.
Moores Cancer Center, University of California San Diego, La Jolla, CA 92093, USA.
Int J Environ Res Public Health. 2020 Nov 12;17(22):8364. doi: 10.3390/ijerph17228364.
High-level exposure to arsenic, a known carcinogen and endocrine disruptor, is associated with prostate cancer (PCa) mortality. Whether low-level exposure is associated with PCa aggressiveness remains unknown. We examined the association between urinary arsenic and PCa aggressiveness among men in North Carolina. This cross-sectional study included 463 African-American and 491 European-American men with newly diagnosed, histologically confirmed prostate adenocarcinoma. PCa aggressiveness was defined as low aggressive (Gleason score < 7, stage = cT1-cT2, and PSA < 10 ng/mL) versus intermediate/high aggressive (all other cases). Total arsenic and arsenical species (inorganic arsenic (iAs + iAs), arsenobetaine, monomethyl arsenic, and dimethyl arsenic)) and specific gravity were measured in spot urine samples obtained an average of 23.7 weeks after diagnosis. Multivariable logistic regression was used to estimate the covariate-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for PCa aggressiveness in association with arsenic tertiles/quantiles overall and by race. The highest (vs. lowest) tertile of total arsenic was associated with PCa aggressiveness ORs of 1.77 (95% CI = 1.05-2.98) among European-American men, and 0.94 (95% CI = 0.57-1.56) among African-American men ( = 0.04). In contrast, total arsenic and arsenical species were not associated with PCa aggressiveness in unstratified models. Low-level arsenic exposure may be associated with PCa aggressiveness among European-Americans, but not among African-Americans.
高水平的砷暴露，一种已知的致癌物质和内分泌干扰物，与前列腺癌（PCa）死亡率有关。低水平暴露是否与 PCa 的侵袭性有关仍不清楚。我们研究了北卡罗来纳州男性尿液砷与 PCa 侵袭性之间的关系。这项横断面研究包括 463 名非裔美国人和 491 名欧洲裔美国男性，他们患有新诊断的组织学证实的前列腺腺癌。PCa 的侵袭性定义为低侵袭性（Gleason 评分<7，分期=cT1-cT2，PSA<10ng/ml）与中/高侵袭性（所有其他病例）。在诊断后平均 23.7 周采集的尿液样本中测量了总砷和砷化物（无机砷（iAs+iAs）、砷甜菜碱、单甲基砷和二甲基砷）和比重。多变量逻辑回归用于估计砷三分位/四分位数与 PCa 侵袭性之间的协变量调整比值比（OR）和 95%置信区间（CI），以及按种族分层的结果。与最低三分位相比，欧洲裔美国男性中总砷最高（vs. 最低）三分位与 PCa 侵袭性的 OR 为 1.77（95%CI=1.05-2.98），而非裔美国男性的 OR 为 0.94（95%CI=0.57-1.56）（=0.04）。相比之下，总砷和砷化物在未分层模型中与 PCa 侵袭性无关。低水平的砷暴露可能与欧洲裔美国人的 PCa 侵袭性有关，但与非裔美国人无关。
