Finasteride and high-grade prostate cancer in the prostate cancer prevention trial
Finasteride and high-grade prostate cancer in the prostate cancer prevention trial
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DOI：
10.1093/jnci/djm117
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发表时间：
2007-09-19
影响因子：
10.3
通讯作者：
Thompson, Ian M.
中科院分区：
文献类型：
--
作者：
Lucia, M. Scott;Epstein, Jonathan I.;Thompson, Ian M.
前列腺癌预防试验（PCPT）报告，与安慰剂相比，使用芬鲁胺后，前列腺癌的总体发病率降低，但高级别前列腺癌的发病率增加。我们评估了PCPT中与非那肽相关的高级别前列腺癌的增加是否是由于非那肽对肿瘤形态或前列腺大小的潜在影响。（n = 90，非那肽; n = 52，安慰剂）进行组织学检查激素的影响，并与Gleason评分7 - 10（n = 282，芬普胺; n = 244，安慰剂）检查疾病程度的病理学替代物。在活检时测量前列腺体积。对根治性乳腺切除术的样本（n = 222，finalde; n = 306，安慰剂）进行肿瘤分级和范围检查，并在可能的情况下，比较两组之间活检和乳腺切除术的分级。使用逻辑回归分析治疗组之间在病理标准方面的差异。结果在高级别活检组织中，非那肽组和安慰剂组的退行性激素变化相当，但非那肽组的前列腺体积较低（中位数= 25.1 vs 34.4 cm（3），P <0.05）。
Background The Prostate Cancer Prevention Trial (PCPT) reported a decreased incidence of prostate cancer overall but an increase in the incidence of high-grade prostate cancer with finasteride compared with placebo. We assessed whether the increased high-grade prostate cancer associated with finasteride in the PCPT was due to finasteride's potential effects oh tumor morphology or prostate size.Methods Prostate biopsies with Gleason score 8-10 (n = 90, finasteride; n 52, placebo) were examined histologically for hormonal effects, and those with Gleason score 7-10 (n 282, finasteride; n = 244, placebo) were examined for pathologic surrogates of disease extent. Prostate volumes were measured at biopsy. Samples from radical prostatectomies (n = 222, finasteride; n = 306, placebo) were examined for tumor grade and extent, and, where possible, grades at biopsy and prostatectomy were compared between the groups. Logistic regression was used to analyze differences between treatment groups with respect to pathologic criteria. All statistical tests were two-sided.Results Degenerative hormonal changes in high-grade biopsies were equivalent between the finasteride and placebo groups, but prostate volumes were lower in the finasteride group (median = 25.1 versus 34.4 cm(3), P