Gaglani Simita, Purohit Rajveer S, Tewari Ashutosh K, Kyprianou Natasha, Lundon Dara J
Department of Urology, Icahn School of Medicine at Mount Sinai New York, USA.
Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai New York, USA.
Am J Clin Exp Urol. 2022 Apr 15;10(2):63-72. eCollection 2022.
Transgender women, who were assigned male at birth but identify as women, may take several steps to merge their physical and psychological identities, including gender-affirming surgeries and hormone therapy. With the presence of the mature prostate gland there persists a risk for malignant transformation in this population. The recognition by the medical community and society at large that transgender women are at risk of developing prostate cancer has recently been supported by investigative efforts. The slowly emerging clinical evidence suggests that the disease is likely to be more aggressive than in cisgender men, with 6 of 9 published cases discussing metastasis reporting metastatic disease on presentation. Currently the overall prevalence appears low, pointing to evolving awareness, educational status, socioeconomic status, and late presentation. This commentary focuses on exploring the factors contributing to the incidence of prostate cancer and the biochemical and endocrine mechanisms that lead to aggressive prostate tumor development in transgender women.
出生时被认定为男性但自我认同为女性的跨性别女性，可能会采取多种措施来融合其生理和心理身份，包括性别确认手术和激素治疗。由于该人群中存在成熟的前列腺，因此仍有发生恶性转化的风险。医学界和整个社会对跨性别女性患前列腺癌风险的认识最近得到了调查研究的支持。逐渐出现的临床证据表明，这种疾病可能比顺性别男性的侵袭性更强，9例已发表病例中有6例讨论了转移情况，报告称就诊时即有转移性疾病。目前总体患病率似乎较低，这表明人们的认识、教育程度、社会经济地位以及就诊延迟等情况都在不断变化。本评论重点探讨导致跨性别女性前列腺癌发病率的因素，以及导致侵袭性前列腺肿瘤发生的生化和内分泌机制。
