Prevalence of Prostate Cancer on Autopsy: Cross-Sectional Study on Unscreened Caucasian and Asian Men
Prevalence of Prostate Cancer on Autopsy: Cross-Sectional Study on Unscreened Caucasian and Asian Men
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DOI：
10.1093/jnci/djt151
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发表时间：
2013-07-01
影响因子：
10.3
通讯作者：
van der Kwast, Theodorus H.
中科院分区：
文献类型：
--
作者：
Zlotta, Alexandre R.;Egawa, Shin;van der Kwast, Theodorus H.
前列腺癌（PCa）的发病率和死亡率存在显著的地理差异，亚洲（ASI）男性的发病率和死亡率低于高加索（CAU）男性。我们前瞻性地比较了CAU和ASI男性中前列腺癌的患病率，这些患者来自前列腺特异性抗原筛查率低的特定人群。前列腺腺体前瞻性地从俄罗斯莫斯科（CAU）和日本东京（ASI）死于前列腺癌以外原因的男性尸检中获得。整块取出前列腺并进行整体分析。我们使用（2）、MannWhitneyWilcoxon检验和多元logistic回归分析比较了两个人群的PCa患病率、肿瘤病灶的数量和Gleason评分（GS）、病理分期、空间位置和肿瘤体积。所有的统计检验都是双侧的，共收集了320个前列腺，220个来自CAU男性，100个来自ASI平均值。CAU男性的平均年龄为62.5岁，ASI男性的平均年龄为68.5岁（P < .001）。观察到CAU男性中PCa患病率为37.3%，ASI男性中为35.0%（P 0.70）。平均肿瘤体积为0.303cm（3）。在60岁以上的男性中，在超过40%的前列腺中观察到PCa，在80岁以上的男性中达到近60%。GS7或更高的癌症分别占CAU和ASI男性所有PCa的23.1%和51.4%（P 0.003）。当调整年龄和前列腺重量后，ASI男性仍然有更大的概率患有GS 7或更高的PCa（P 0.03）。ASI中超过50%的癌症和CAU男性中近25%的癌症具有7或更高的GS。我们的研究结果表明，临床上无意义的PCa的定义可能值得重新审视。
Substantial geographical differences in prostate cancer (PCa) incidence and mortality exist, being lower among Asian (ASI) men compared with Caucasian (CAU) men. We prospectively compared PCa prevalence in CAU and ASI men from specific populations with low penetrance of prostate-specific antigen screening.Prostate glands were prospectively obtained during autopsy from men who died from causes other than PCa in Moscow, Russia (CAU), and Tokyo, Japan (ASI). Prostates were removed en-block and analyzed in toto. We compared across the 2 populations PCa prevalence, number and Gleason score (GS) of tumour foci, pathological stage, spatial location, and tumor volume using (2), MannWhitneyWilcoxon tests, and multiple logistic regression. All statistical tests were two-sided.Three hundred twenty prostates were collected, 220 from CAU men and 100 from ASI mean. The mean age was 62.5 in CAU men and 68.5 years in ASI men (P < .001). PCa prevalences of 37.3% in CAU men and 35.0% in ASI men were observed (P .70). Average tumor volume was 0.303cm(3). In men aged greater than 60 years, PCa was observed in more than 40% of prostates, reaching nearly 60% in men aged greater than 80 years. GS 7 or greater cancers accounted for 23.1% and 51.4% of all PCa in CAU and ASI men, respectively, (P .003). When adjusted for age and prostate weight, ASI men still had a greater probability of having GS 7 or greater PCa (P .03).PCa is found on autopsy in a similar proportion of Russian and Japanese men. More than 50% of cancers in ASI and nearly 25% of cancers in CAU men have a GS of 7 or greater. Our results suggest that the definition of clinically insignificant PCa might be worth re-examining.