Height and prostate cancer risk: a large nested case-control study (ProtecT) and meta-analysis.
Height and prostate cancer risk: a large nested case-control study (ProtecT) and meta-analysis.
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DOI：
10.1158/1055-9965.epi-08-0342
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发表时间：
2008-09
期刊：
影响因子：
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通讯作者：
Martin RM
中科院分区：
文献类型：
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作者：
Zuccolo L;Harris R;Gunnell D;Oliver S;Lane JA;Davis M;Donovan J;Neal D;Hamdy F;Beynon R;Savovic J;Martin RM
身高是儿童期环境暴露的标志，可能通过胰岛素样生长因子系统与前列腺癌风险呈正相关。我们在巢式病例对照研究中调查了前列腺癌与身高及其组成部分（腿和躯干长度）的关系，并在剂量反应荟萃分析中调查了前列腺癌与身高的关系。我们在一项基于人群的随机对照试验中嵌套了一项病例对照研究，该试验评估了50至69岁英国男性局限性前列腺癌的治疗方法，包括通过前列腺特异性抗原检测检测的1，357例病例和7，990例对照（年龄，一般实践，评估日期匹配）。系统地检索了9个文献数据库，在荟萃分析中汇总了关于身高与前列腺癌相关性的研究。基于巢式病例对照，身高每增加10厘米，前列腺特异性抗原检测到前列腺癌的比值比（OR）为1.06 [95%置信区间（95%CI）：0.97-1.16; ptrend = 0.2]。有更强的证据表明身高与高级别前列腺癌相关（OR：1.23; 95%CI：1.06-1.43），主要是由于腿部成分，但与低级别疾病无关（OR：0.99; 95%CI：0.90-1.10）。一般来说，与腿或躯干长度的关联是相似的。一项对58项研究的荟萃分析发现，身高与前列腺癌呈正相关（随机效应OR/10 cm：1.06; 95% CI：1.03-1.09），对更晚期/侵袭性癌症的前瞻性研究影响更大（随机效应OR：1.12; 95% CI：1.05-1.19）。这些数据表明，儿童期环境因素对前列腺癌发病率的作用有限（以成人身高为指标），而对进展的作用更大，其机制需要进一步研究。
Height, a marker of childhood environmental exposures, is positively associated with prostate cancer risk, perhaps through the insulin-like growth factor system. We investigated the relationship of prostate cancer with height and its components (leg and trunk length) in a nested case-control study and with height in a dose-response meta-analysis. We nested a case-control study within a population-based randomized controlled trial evaluating treatments for localized prostate cancer in British men ages 50 to 69 years, including 1,357 cases detected through prostate-specific antigen testing and 7,990 controls (matched on age, general practice, assessment date). Nine bibliographic databases were searched systematically for studies on the height-prostate cancer association that were pooled in a meta-analysis. Based on the nested case-control, the odds ratio (OR) of prostate-specific antigen-detected prostate cancer per 10 cm increase in height was 1.06 [95% confidence interval (95% CI): 0.97-1.16; ptrend = 0.2]. There was stronger evidence of an association of height with high-grade prostate cancer (OR: 1.23; 95% CI: 1.06-1.43), mainly due to the leg component, but not with low-grade disease (OR: 0.99; 95% CI: 0.90-1.10). In general, associations with leg or trunk length were similar. A meta-analysis of 58 studies found evidence that height is positively associated with prostate cancer (random-effects OR per 10 cm: 1.06; 95% CI: 1.03-1.09), with a stronger effect for prospective studies of more advanced/aggressive cancers (random-effects OR: 1.12; 95% CI: 1.05-1.19). These data indicate a limited role for childhood environmental exposures—as indexed by adult height—on prostate cancer incidence, while suggesting a greater role for progression, through mechanisms requiring further investigation.