前列腺癌患者的低水平和死亡风险:随机化后分析.
Sayeh Fattahi1, Ming-Hui Chen2, Jing Wu3
1Department of Radiation Oncology, Brigham and Women's Hospital and Dana Farber Cancer Institute, Boston, Massachusetts, USA.
Cancer medicine
|August 1, 2025
概括
患有前列腺癌 (PC) 的男性丸激素水平较低与较高的死亡风险有关,特别是在并发症最小的男性中. 早期诊断和风险分层对于改善PC患者的治疗结果至关重要.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 在瘤学瘤学.
- 内分泌学 在内分泌学.
背景情况:
- 低血清丸激素可以通过延长前列腺特异抗原 (PSA) 超过正常水平的时间来延迟前列腺癌 (PC) 诊断.
- 这项研究调查了PC的攻击性和死亡风险与丸激素水平相关的共发病亚组.
研究的目的:
- 评估低血清丸激素与正常血清丸激素对PC攻击性和死亡率的影响.
- 评估PC特异性和所有原因死亡 (PCSM,ACM) 风险在并发症子组内.
主要方法:
- 一个随机试验队列的350不良风险的PC患者 (T1c-4N0M0) 在2005-2015年间.
- 用精细和灰色和考克斯回归分析来评估PCSM和ACM风险,并根据预后因素和治疗进行调整.
- 一个相互作用术语评估了丸激素在不同并发症水平 (成人并发症评估-27) 上的影响.
主要成果:
- 平均随访时间为10.2年后,89名患者死亡 (25.43%),其中47.19%的死亡是由于PC.
- 在没有或最小的并发症的患者中,低丸激素与正常丸激素相比显著增加PCSM (AHR: 2.70) 和ACM (AHR: 1.90).
- 在中度至重度并发症的患者中没有观察到显著的关联.
结论:
- 低血清丸激素是一个独立的风险因素,可增加PC特异性和所有原因死亡率在男性中,并发病率最小.
- 多参数核磁共振扫描 (mpMRI) 不受水平的影响,可以帮助PC查和风险分层.
- 进一步的研究应该考虑将mpMRI纳入PC查协议中,用于低丸激素患者,以潜在地减少PCSM.
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