研究人員跟蹤調(diào)查了1319名實施根治性前列腺切除手術(shù)的患者,，其中236人術(shù)前服用了他汀類藥物。手術(shù)后,，研究人員檢測患者體內(nèi)的前列腺特異性抗原水平,，以評估其前列腺癌生化復(fù)發(fā)率。
前列腺特異性抗原是前列腺腫瘤的標(biāo)志物之一,，檢測前列腺特異性抗原在前列腺癌患者療效評估和隨訪中起著重要作用,。部分經(jīng)根治性切除治療的患者術(shù)后前列腺特異性抗原5年內(nèi)會升高，即生化復(fù)發(fā),。一般認(rèn)為,，生化復(fù)發(fā)是疾病復(fù)發(fā)的最早表現(xiàn)。
研究人員發(fā)現(xiàn),，共有304名患者術(shù)后5年內(nèi)前列腺特異性抗原水平升高,，其中服用他汀類藥物者37人，未服藥者267人,。經(jīng)過校正多項臨床與病理危險因素,，研究人員認(rèn)為，他汀類藥物可將前列腺癌患者術(shù)后的生化復(fù)發(fā)率降低30%,。
這項研究成果發(fā)表在最新一期《癌癥》雜志上,。參與研究的史蒂芬·弗雷德蘭德認(rèn)為，這項研究表明,，他汀類藥物或可在減緩前列腺癌生長和擴散過程中發(fā)揮重要作用,。(生物谷www.bioon.net)
生物谷推薦原文出處：
Cancer DOI:10.1002/cncr.25308
Statin medication use and the risk of biochemical recurrence after radical prostatectomy
Robert J. Hamilton, MD, MPH 1 2, Lionel L. Banez, MD 1 3, William J. Aronson, MD 4 5, Martha K. Terris, MD 6 7, Elizabeth A. Platz, ScD, MPH 8 9, Christopher J. Kane, MD 10, Joseph C. Presti Jr, MD 11 12, Christopher L. Amling, MD 13 14, Stephen J. Freedland, MD 1 3 *
1Division of Urologic Surgery, Department of Surgery, Duke University School of Medicine, Durham, North Carolina
2Division of Urology, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
3Section of Urology, Veterans Affairs Medical Center Durham, North Carolina
4Urology Section, Department of Surgery, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California
5Department of Urology, University of California at Los Angeles School of Medicine, Los Angeles, California
6Section of Urology, Veterans Affairs Medical Center, Augusta, Georgia
7Section of Urology, Medical College of Georgia, Augusta, Georgia
8Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
9James Buchanan Brady Urological Institute, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Medical Institutions, Baltimore, Maryland
10Division of Urology, University of California, San Diego, San Diego, California
11Department of Urology, Stanford University School of Medicine, Palo Alto, California
12Section of Urology, Veterans Affairs Medical Center, Palo Alto, California
13Division of Urology, University of Alabama at Birmingham, Birmingham, Alabama
14Section of Urology, Veterans Affairs Medical Center, Birmingham, Alabama
BACKGROUND:
Although controversial, evidence suggests statins may reduce the risk of advanced prostate cancer (PC), and recently statin use was associated with prostate-specific antigen (PSA) reductions among men without PC. The authors sought to examine the association between statin use and PSA recurrence after radical prostatectomy (RP).
METHODS:
The authors examined 1319 men treated with RP from the Shared Equal Access Regional Cancer Hospital (SEARCH) Database. Time to PSA recurrence was compared between users and nonusers of statin at surgery using Cox proportional hazards models adjusted for multiple clinical and pathological features.
RESULTS:
In total, 236 (18%) men were taking statins at RP. Median follow-up was 24 months for statin users and 38 for nonusers. Statin users were older (P < .001) and underwent RP more recently (P < .001). Statin users were diagnosed at lower clinical stages (P = .009) and with lower PSA levels (P = .04). However, statin users tended to have higher biopsy Gleason scores (P = .002). After adjusting for multiple clinical and pathological factors, statin use was associated with a 30% lower risk of PSA recurrence (hazard ratio HR, 0.70; 95% confidence interval CI, 0.50-0.97; P = .03), which was dose dependent (relative to no statin use; dose equivalent<simvastatin 20 mg: HR, 1.08; 95% CI, 0.66-1.73; P = .78; dose equivalent = simvastatin 20 mg: HR, 0.57; 95% CI, 0.32-1.00; P = .05; dose equivalent>simvastatin 20 mg: HR, 0.50; 95% CI, 0.27-0.93; P = .03).
CONCLUSIONS:
In this cohort of men undergoing RP, statin use was associated with a dose-dependent reduction in the risk of biochemical recurrence. If confirmed in other studies, these findings suggest statins may slow PC progression after RP.
