美国一项最新研究显示，无论对黑人男性还是白人男性来说，肥胖症都会增加前列腺癌复发的危险。这一发现推翻了“罹患肥胖症的黑人男性更容易出现前列腺癌复发”的传统观点。
美国杜克大学医学中心研究人员在8月出版的《癌症》杂志上发表报告说，肥胖症会导致前列腺癌复发，这一结论不会因患者肤色的不同而变化。研究人员对1415位前列腺癌患者进行了跟踪研究，其中既有黑人也有白人，并且都接受了前列腺切除手术。研究发现，凡体重超重的前列腺癌患者，无论是黑人还是白人，其前列腺癌复发率都要高于体重正常的前列腺癌患者。
论文主要作者贾亚钱德兰解释说，肥胖症会提高前列腺癌患者体内的雌激素水平，同时减少睾丸激素，而后者的减少可能与肿瘤发展有一定关联。此外，肥胖症还会破坏前列腺癌患者体内其他激素的平衡，如胰岛素和瘦素等，这些变化会加快前列腺癌的发展。（生物谷Bioon.com）
生物谷推荐原始出处：
Cancer 10 Aug 2009 DOI:10.1002/cncr.24571
Obesity as a predictor of adverse outcome across black and white race
Results from the Shared Equal Access Regional Cancer Hospital (SEARCH) Database
Jayakrishnan Jayachandran, MD 1 2, Lionel L. Ba?ez, MD 1 2, William J. Aronson, MD 3 4, Martha K. Terris, MD 5 6, Joseph C. Presti Jr., MD 7 8, Christopher L. Amling, MD 9 10, Christopher J. Kane, MD 11, Stephen J. Freedland, MD 1 2 *, the SEARCH Database Study Group
1Division of Urologic Surgery, Departments of Surgery and Pathology, and the Duke Prostate Center, Duke University School of Medicine, Durham, North Carolina
2Urology Section, Veterans Affairs Medical Center, Durham, North Carolina
3Urology Section, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California
4Department of Urology, University of California at Los Angeles School of Medicine, Los Angeles, California
5Urology Section, Veterans Affairs Medical Center Augusta, Georgia
6Section of Urology, Medical College of Georgia, Augusta, Georgia
7Department of Urology, Stanford University School of Medicine, Palo Alto, California
8Urology Section, Veterans Affairs Medical Center, Palo Alto, California
9Division of Urology, University of Alabama at Birmingham, Birmingham, Alabama
10Urology Section, Birmingham Veterans Affairs Medical Center, Birmingham, Alabama
11Division of Urology, University of California, San Diego School of Medicine, San Diego, California
BACKGROUND:
Across multiple studies, obesity has been associated with an increased risk of higher grade disease and prostate-specific antigen (PSA) recurrence after radical prostatectomy (RP). Whether these associations vary by race is unknown. In the current study, the authors examined the association between obesity and outcome after RP stratified by race.
METHODS:
A retrospective analysis was performed on 1415 men in the Shared Equal Access Regional Cancer Hospital (SEARCH) database who underwent RP between 1989 and 2008. The association between increased body mass index (BMI) and adverse pathology and biochemical recurrence was examined using multivariate logistic regression and Cox models, respectively. Data were examined stratified by race.
RESULTS:
After adjusting for preoperative clinical characteristics, higher BMI was associated with higher tumor grade (P = .008) and positive surgical margins (P < .001) in white men, and similar but statistically nonsignificant trends were observed in black men. No significant interaction was noted between race and BMI for associations with adverse pathology (Pinteraction.12). After adjusting for preoperative clinical characteristics, higher BMI was associated with an increased risk of recurrence in both white men (P = .001) and black men (P = .03). After further adjusting for pathologic variables, higher BMI was associated with significantly increased risk of recurrence in white men (P = .002) and black men (P = .01). No significant interactions were observed between race and BMI for predicting biochemical progression adjusting either for preoperative factors (Pinteraction = .35) or for preoperative and pathologic features (Pinteraction = .47).
CONCLUSIONS:
Obesity was associated with a greater risk of recurrence among both black men and white men. Obesity did not appear to be more or less influential in 1 race than another but, rather, was identified as a risk factor for aggressive cancer regardless of race. Cancer 2009. ? 2009 American Cancer Society.
