Understanding the Epidemiology, Natural History, and Key Pathways Involved in Prostate Cancer
Understanding the Epidemiology, Natural History, and Key Pathways Involved in Prostate Cancer
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DOI：
10.1016/j.urology.2009.03.001
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发表时间：
2009-05-01
期刊：
影响因子：
2.1
通讯作者：
Crawford, E. David
中科院分区：
文献类型：
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作者：
Crawford, E. David
前列腺癌约占美国男性所有新确诊癌症的25%，预计在2008年导致超过28000人死亡。黑人男性受到的影响尤为严重；他们的发病率约为白人男性的1.6倍。随着人口老龄化，预计每年新增病例数将增加60%以上，到2015年将达到30万例。这种高发病率，加上疾病发病过程漫长，使得前列腺癌成为预防和早期干预策略的特别合适的对象。潜在的疾病前体，特别是高级别前列腺上皮内瘤变，可能有助于识别患前列腺癌高风险的男性。双氢睾酮是由睾酮经5α - 还原酶转化而来的产物，在正常前列腺生长和前列腺癌的发展中起着重要作用。5α - 还原酶水平，特别是1型，在前列腺上皮内瘤变和前列腺癌的病程中似乎会升高，且随着疾病进展表达量增加。因此，抑制5α - 还原酶可能潜在地降低前列腺癌发生的风险，减缓或阻止疾病进展，和/或治疗现有疾病。最近大量的研究工作集中在了解该疾病发生和进展所涉及的途径，特别是5α - 还原酶途径。《泌尿学》73（增刊5A）：4 - 10，2009年。（C）2009年由爱思唯尔公司出版。
Prostate cancer accounts for about 25% of all the newly diagnosed cancers in American men and was projected to cause >28 000 deaths in 2008. Black men are disproportionately affected; their incidence rate is about 1.6 times greater than the rate for white men. As the population ages, the number of new cases per year is expected to increase by >60% and reach 300 000 by 2015. This high incidence, coupled with the protracted onset of the disease, makes PCa a particularly appropriate candidate for prevention and early intervention strategies. Potential disease precursors, particularly high-grade prostatic intraepithelial neoplasia, might help identify men at high risk of developing PCa. Dihydrotestosterone, a product converted from testosterone by 5 alpha-reductases, plays an important role in normal prostate growth and in the development of PCa. The 5 alpha-reductase levels, particularly type 1, appear to increase during the disease course of prostatic intraepithelial neoplasia and PCa, with greater expression occurring as the disease progresses. Therefore, the inhibition of 5 alpha-reductase could potentially reduce the risk of PCa development, slow or prevent disease progression, and/or treat existing disease. A substantial research effort has recently focused on understanding the pathways involved in the disease's emergence and progression, particularly the 5a-reductase pathway. UROLOGY 73 (Suppl 5A): 4-10, 2009. (C) 2009 Published by Elsevier Inc.