他汀类药物与前列腺癌发生风险:一项基于人群的纵向队列研究  

Statins and risk of prostate cancer: a population-based longitudinal cohort study

作　　者：杨明根[1] 郑周达[1] 许振强[1] 郑艺淑[1] 

机构地区：[1]福建医科大学附属漳州市医院泌尿外科,福建漳州363000

出　　处：《肿瘤》2016年第9期1000-1005,共6页Tumor

基　　金：福建省卫生系统中青年骨干人才培养项目

摘　　要：目的：探讨他汀类药物与前列腺癌发生风险的相关性。方法：选择2008年1月-2010年12月在福建医科大学附属漳州市医院体检中心接受体检的符合纳入标准的50～75岁的男性作为研究对象，随访5年。通过比较非他汀类药物组和他汀类药物组的血清前列腺特异性抗原水平、前列腺穿刺活检率、前列腺癌发生率、Gleason评分和5年生存率，探讨他汀类药物与前列腺癌发生风险之间的相关性。结果：共1391例老年男性符合研究对象选择标准。其中，非他汀类药物组717例，平均年龄为（60．1±4．1）岁；他汀类药物组674例，平均年龄为（60．4±4．2）岁。2组的年龄、合并疾病、前列腺癌家族史和基线期血清前列腺特异性抗原水平的差异均无统计学意义（P值均〉0．05）。非他汀类药物组有15例（2．1％）失访，他汀类药物组有13例（1．9％）失访。5年随访期间，非他汀类药物组和他汀类药物组血清总的前列腺特异性抗原水平、前列腺穿刺率和前列腺癌发生率均逐渐升高，且非他汀类药物组总的升高趋势较他汀类药物组更明显（P〈0．05）。他汀类药物组中，不同药物亚组之间上述观察指标的差异均无统计学意义（P值均〉0．05）。他汀类药物组中确诊为前列腺癌患者的比例低于非他汀类药物组（P〈0．001），患者年龄高于非他汀类药物组（P〈0．001），高组织学分级（Gleason评分≥7）前列腺癌的比例低于非他汀类药物组（P〈0．001）。结论：他汀类药物可能降低前列腺癌发生风险，长期用药的效果更为显著。Objective： To determine the association of statins use with prostate cancer risk. Methods： A retrospective population-based longitudinal cohort study was conducted, including eligible men at age of 50-75 years who received physical examination in Zhangzhou Hospital Affiliated to Fujian Medical University between January 2008 and December 2010. The follow-up was performed for 5 years. The serum total prostate-specific antigen （TPSA） level, the prostate biopsy rate （PBR）, the rate of prostate cancer diagnosis （RPCD）, Gleason garde and 5-year survival between statins use group and non-statins use group were compared to evaluate the association of statins with prostate cancer risk. Results： Total of 1 391 eligible elderly males were recruited in this study, of which there were 717 patients with a median age of 60.1±4.1 years in non-statins use group and 674 patients with a median age of 60.4±4.2 years in statins use group. There were no significant differences in age, complications, family history of prostate cancer and serum TPSA level between two groups （all P 〉 0.05）. In the non-statins use group and statins use group, 15 （2.1%） and 13 （1.9%） patients were lost to follow-up, respectively. In the period of 5-year follow-up, a trend of increase in serum TPSA level, PBR and RPCD was observed in both groups, and the degree of increase was significantly higher in non-statins use group （P 〈 0.05）. In statins use group, there were no significant differences in serum TPSA level, PBR and RPCD among different statins subgroups （all P 〉 0.05）. The incidence rate of prostate cancer of statins use group was significantly lower than that of the non-statins use group （P 〈 0.001）. Furthermore, the patients diagnosed of prostate cancer in the statins use group were older than the patients in the non-statins use group （P 〈 0.001）, and the proportion of high- grade cancer （Gleason score ≥7）was lower （P 〈 0.001）. Conclusion： Statins may be associated with a decre

关 键 词：前列腺肿瘤 他汀类 人群研究 

分 类 号：R737.25[医药卫生—肿瘤]