肥胖、血脂与前列腺癌发生及进展的关系

The relationship between obesity/blood lipid and occurrence/progression of prostate cancer

目的研究前列腺癌发生及进展的危险因素,探讨肥胖、血脂及脂蛋白等因素与前列腺癌的关系,为前列腺癌的临床诊治提供参考。方法回顾性收集我院泌尿外科2013年1月至2016年11月,行"经B超引导下经直肠前列腺穿刺活检术"患者的病历资料,采用单因素和多因素Logistic回归分析,分析前列腺癌危险因素。结果 (1)总计428例患者行"经直肠B超引导下前列腺穿刺活检术",术后病理确诊为非前列腺癌患者255例(59.6%)。前列腺癌组中,肥胖人群(BMI≥25kg/m^2)、有吸烟史、高血压病史、高胆固醇血症患者比例显著高于非前列腺癌组(P<0.05)。两组患者中有饮酒史、糖尿病史、高甘油三脂血症和高低密度脂蛋白血症等患者比例差异无统计学意义(P>0.05)。多因素Logistic回归分析结果显示年龄、吸烟、高血压、前列腺特异性抗原和肥胖是穿刺阳性前列腺癌的独立危险因素(P<0.05)。(2)前列腺癌高危组和非高危组Logistic回归分析结果显示肥胖和PSA是高危前列腺癌的独立危险因素,载脂蛋白A1(Apo A1)是高危前列腺癌的保护因素,差异有统计学意义(P<0.05)。结论年龄、吸烟和肥胖是前列腺癌发生的独立危险因素。肥胖是高危前列腺癌的独立危险因素;Apo A1是高危前列腺癌保护因素。

Objective To investigate the risk factors of occurrence and progression of prostate cancer and analyze the relationship between obesity,blood lipids/lipoprotein and prostate cancer. Thus, provide appropriate reference for clinical diagnosis and treatment of the cancer. Methods Clinical data of patients with ultrasound-guided rectal prostate biopsy from January 2013 to November 2016 in our department were collected. The risk factors of prostate cancer were retrospoctively analyzed by using single factor and multivariate logistic regression. Results A total of 428 patients underwent the trans-rectal ultrasound-guided prostate biopsy. Of these patients,255 cases （59. 6% ） were diagnosed as non-prostate cancer. The incidence of obesity （BMI ≥ 25 kg/m^2 ） ,smoking history,hypertension and hypercholesterolemia in the cancer patients was significantly higher than that in the non-prostate patients （P 〈 0.05 ）. There was no significant difference in history of drinking, diabetes mellitus, hypertriglyceridemia and high-or low-density lipoproteinemia were found between the two groups （P 〉 0. 05）. Multivariate logistic regression analysis showed that age, smoking, hypertension, PSA and obesity were independent risk factors for puncture-positive prostate cancer （P 〈 0. 05 ）. Moreover, logistic regression analysis showed that obesity and PSA were independent risk factors while apolipoprotein A1 was a protective factor at high risk of prostate cancer （P 〈 0.05）. Conclusion Age, smoking and obesity are independent risk factors＇ for occurrence of prostate cancer. Obesity is a risk factor while apolipoprotein A1 is a protection factor at high risk of prostate cancer.