免疫功能低下患者的前列腺癌结局:系统性审查和元分析
Francesco Sanguedolce1, Alessandro Tedde2, Giuseppe Basile3
1Department of Urology, Fundació Puigvert, Barcelona, Spain; Department of Medicine, Surgery and Pharmacy, Università degli Studi di Sassari, Sassari, Italy.
European urology oncology
|June 18, 2025
概括
前列腺癌 (PCa) 患者的免疫抑制不会显著增加癌症特异性死亡率 (CSM),但整体死亡率 (OM) 较高. 移植接受者与对照者具有类似的CSM,而HIV患者面临CSM风险升高.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 流行病学 流行病学
背景情况:
- 免疫抑制对前列腺癌 (PCa) 死亡率的影响尚不清楚,现有证据有限.
- 本综述通过比较免疫功能低下与免疫能力较强的PCa患者的癌症特异性死亡率 (CSM) 和整体死亡率 (OM) 来解决这一争论.
研究的目的:
- 系统地评估免疫抑制与前列腺癌死亡率之间的关联.
- 为了比较癌症特异性死亡率 (CSM) 和总死亡率 (OM) 在免疫功能低下和免疫能力强的前列腺癌患者.
主要方法:
- 在PubMed/Medline,Embase和Web of Science数据库中进行了全面的文献搜索,截至2024年3月31日.
- 按照PRISMA指南进行了系统审查和元分析,使用固定效应模型与调整的危险比率 (HRs) 汇集数据.
- 包括13项研究,包括大约340万PCa患者进行定性分析,11项用于定量分析.
主要成果:
- 总的来说,免疫抑制并没有显著增加前列腺癌患者的癌症特异性死亡率 (CSM) (HR1.04;p=0.57).
- 然而,免疫功能低下患者的整体死亡率 (OM) 显著增加 (HR 2.04;p<0.001).
- 移植受体的CSM与对照组相比较 (HR 1.01; p=0.94),但患有人类免疫缺陷病毒 (HIV) 的患者的CSM显著更高 (HR 1.83; p=0.004).
结论:
- 经过移植的前列腺癌患者的癌症特异性死亡率与免疫能力强的个体相似,尽管整体死亡率增加.
- 其他免疫功能低下的患者群体,特别是艾滋病毒感染者,面临着更糟糕的预后,癌症特异性死亡率更高.
- 国际指南应该为移植患者的治疗算法提供信息,倡导更积极的治疗和查策略.
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