Association of obesity and smoking with PSA and PSA velocity in men with prostate cancer.
Association of obesity and smoking with PSA and PSA velocity in men with prostate cancer.
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DOI：
10.1177/1557988310390030
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发表时间：
2011-05
期刊：
影响因子：
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通讯作者：
Thompson PA
中科院分区：
文献类型：
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作者：
Algotar AM;Stratton SP;Ranger-Moore J;Stratton MS;Hsu CH;Ahmann FR;Nagle RB;Thompson PA
大量前列腺肿瘤生长缓慢，可能无法治疗。然而，许多是侵略性的，可以迅速传播，导致患者痛苦和/或死亡。目前的技术不允许医生在诊断时区分缓慢生长和侵袭性肿瘤。因此，许多患者暴露于侵入性治疗及其相关的发病率，如失禁和阳痿。能够区分缓慢和快速进展的癌症的标志物将使医生能够防止对可能不需要的男性进行不必要的治疗，并专注于患有侵袭性疾病的男性。采用混合效应回归模型进行了一项纵向研究（N = 140），以确定肥胖和吸烟与前列腺癌进展的相关性。这些模型解释了相关性，因为随着时间的推移重复测量，因此使用了受试者提供的最大量的信息。由此获得的估计值比使用单个时间点的数据获得的估计值更稳健和可靠。使用前列腺特异性抗原（PSA）随时间的变化率（PSA速度）作为前列腺癌进展的指标。结果表明，超重和肥胖受试者的PSA速率（0.59和1.05 ng/mL/年）与正常体重受试者相比没有显着差异（p值分别为0.91和0.31）。对于吸烟包年数最高三分位数的男性，PSA速率显著高于从不吸烟者1.57 ng/mL/年（p = .04）。在提出减肥或减少/戒烟的建议之前，需要进一步进行更大样本量的研究和针对上述暴露的研究设计。
Significant number of prostate tumors are slow growing and could probably be left untreated. However, many are aggressive and can spread rapidly causing patient suffering and/or death. Current technology does not allow physicians to differentiate between slow growing and aggressive tumors at diagnosis. Hence, many patients are exposed to invasive treatment and its associated morbidities such as incontinence and impotence. Markers that enable differentiation between slow and fast progressing cancer will allow physicians to prevent unnecessary treatments on men who may not need them, and focus on the men with aggressive disease. A longitudinal study was conducted (N = 140) using mixed effects regression models to determine the association of obesity and smoking toward prostate cancer progression. These models account for correlation because of repeated measures over time, thus, using maximum amount of information provided by the subject. Estimates thus obtained are more robust and reliable than those obtained using data from a single time point. Rate of change of prostate-specific antigen (PSA) over time (PSA velocity) was used as a measure of prostate cancer progression. Results indicate that PSA velocity of overweight and obese subjects (0.59 and 1.05 ng/mL/year) was not significantly different as compared with normal weight subjects (p values .91 and .31, respectively). For men in the highest tertile of pack-years of smoking, PSA velocity was significantly higher as compared with never smokers 1.57 ng/mL/year (p = .04). Further studies with larger sample sizes and study designs specific to above exposures are needed before recommendations can be made to reduce weight or reduce/quit smoking.