研究人员跟踪调查了1319名实施根治性前列腺切除手术的患者，其中236人术前服用了他汀类药物。手术后，研究人员检测患者体内的前列腺特异性抗原水平，以评估其前列腺癌生化复发率。
前列腺特异性抗原是前列腺肿瘤的标志物之一，检测前列腺特异性抗原在前列腺癌患者疗效评估和随访中起着重要作用。部分经根治性切除治疗的患者术后前列腺特异性抗原5年内会升高，即生化复发。一般认为，生化复发是疾病复发的最早表现。
研究人员发现，共有304名患者术后5年内前列腺特异性抗原水平升高，其中服用他汀类药物者37人，未服药者267人。经过校正多项临床与病理危险因素，研究人员认为，他汀类药物可将前列腺癌患者术后的生化复发率降低30%。
这项研究成果发表在最新一期《癌症》杂志上。参与研究的史蒂芬·弗雷德兰德认为，这项研究表明，他汀类药物或可在减缓前列腺癌生长和扩散过程中发挥重要作用。(生物谷www.bioon.net)
生物谷推荐原文出处：
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.
