The association of diabetes with risk of prostate cancer defined by clinical and molecular features
The association of diabetes with risk of prostate cancer defined by clinical and molecular features
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DOI：
10.1038/s41416-020-0910-y
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发表时间：
2020-05-29
影响因子：
8.8
通讯作者：
Mucci, Lorelei A.
中科院分区：
文献类型：
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作者：
Feng, Xiaoshuang;Song, Mingyang;Mucci, Lorelei A.
研究背景：前瞻性研究糖尿病与前列腺癌风险之间的关系，这是由临床和分子特征定义的。方法从1986年至2014年，对来自卫生专业人员跟踪研究(HPFS)的49392名男性进行了跟踪调查。自我报告的糖尿病数据在基线时收集，并每两年更新一次。前列腺癌的临床特征包括局限性、晚期、致死性、低级别、中级和高级别。分子特征包括TMPRSS2：ERG和PTEN亚型。COX比例风险回归模型用于评估糖尿病与亚型前列腺癌发病率之间的关系。结果在28年的随访中，我们记录了6733例前列腺癌病例。与无糖尿病男性相比，男性糖尿病患者的总体风险(HR：0.82，95%CI：0.75-0.90)、局部风险(HR：0.82，95%CI：0.74-0.92)、中低度前列腺癌(HR：0.77，95%CI：0.66-0.90；HR：0.77，95%CI：0.65-0.91)均较低。在分子亚型中，ERG阴性和阳性病例的相对危险度分别为0.63(0.42~0.95)和0.72(0.46~1.12)，PTEN完整和缺失病例的相对危险度分别为0.69(0.48~0.98)和0.52(0.19~1.41)。结论：除了为糖尿病和前列腺癌之间的负相关提供先进的证据外，这项研究还首次报道了糖尿病和ERG/PTEN定义的前列腺癌之间的关联。
Background To prospectively examine the association between diabetes and risk of prostate cancer defined by clinical and molecular features. Methods A total of 49,392 men from the Health Professionals Follow-up Study (HPFS) were followed from 1986 to 2014. Data on self-reported diabetes were collected at baseline and updated biennially. Clinical features of prostate cancer included localised, advanced, lethal, low-grade, intermediate-grade, and high-grade. Molecular features includedTMPRSS2: ERGandPTENsubtypes. Cox proportional hazards regression models were used to evaluate the association between diabetes and incidence of subtype-specific prostate cancer. Results During 28 years of follow-up, we documented 6733 incident prostate cancer cases. Relative to men free from diabetes, men with diabetes had lower risks of total (HR: 0.82, 95% CI: 0.75-0.90), localised (HR: 0.82, 95% CI: 0.74-0.92), low-and intermediate-grade prostate cancer (HR: 0.77, 95% CI: 0.66-0.90; HR: 0.77, 95% CI: 0.65-0.91, respectively). For molecular subtypes, the HRs for ERG-negative and ERG-positive cases were 0.63 (0.42-0.95) and 0.72 (0.46-1.12); and for PTEN-intact and PTEN-loss cases were 0.69 (0.48-0.98) and 0.52 (0.19-1.41), respectively. Conclusion Besides providing advanced evidence for the inverse association between diabetes and prostate cancer, this study is the first to report associations between diabetes and ERG/PTEN defined prostate cancers.