目的:我们旨在研究前列腺活检患者代谢综合征(MetS)与前列腺癌(PCa)之间的关系。
方法:在2018年1月至2022年12月之间,根据成人治疗组III(ATPIII)标准对接受经直肠超声(TRUS)前列腺活检的男性进行了MetS调查。临床病理因素,如,直肠指检(DRE),前列腺特异性抗原(PSA),前列腺体积,腰围,体重指数(BMI),年龄,血压,睾丸激素,脂质分布,空腹血糖水平,分析C反应蛋白(CRP)和MetS。
结果:共有908名男性接受了活检,其中492例(51.5%)患有符合ATPIII标准的MetS。活检中诊断为PCa的患者为270例(29.7%)。PCa病例明显年龄较大,与没有PCa的患者相比,前列腺体积较小,PSA值较高,血压较高(p<0.001)。416例MetS患者中有146例(35.0%)患有PCa,而492例(25.2%)无MetS患者中有124例(p<0.001)患有PCa。在270名PCa患者中,174(64.4%)的格里森评分<7,96(35.6%)的格里森评分≥7。在Gleason评分≥7,PSA的患者中,与Gleason评分<7的患者相比,DRE()和核心阳性数量显着升高,而血糖和高密度脂蛋白(HDL)胆固醇水平显着降低(p<0.001)。多因素分析显示,年龄,PSA,积极的DRE,前列腺体积(p<0.001),舒张压,CRP和MetS是唯一与活检时癌症风险较高相关的独立参数(p<0.05)。
结论:我们的研究结果表明,MetS与活检诊断的PCa相关,但与Gleason评分和癌症阳性核心数无关。然而,这些结果应该得到更大的证实,多中心和前瞻性研究。
OBJECTIVE: We aimed to investigate the association between metabolic syndrome (MetS) and prostate cancer (PCa) in patients undergoing prostate biopsy.
METHODS: Between January 2018 and December 2022, MetS was investigated according to Adult Treatment Panel III (ATP III) criteria in men who underwent prostate biopsy with transrectal ultrasound (TRUS). Clinicopathological factors such as, digital rectal examination (DRE), prostate-specific antigen (PSA), prostate volume, waist circumference, body mass index (BMI), age, blood pressure, testosterone, lipid profiles, fasting blood glucose level, C-reactive protein (CRP) and MetS were analyzed.
RESULTS: A total of 908 men underwent biopsies, of which 492 (51.5%) had MetS according to ATP III criteria. The number of patients diagnosed with PCa in biopsy was 270 (29.7%). PCa cases were significantly older, with a lower prostate volume and a higher PSA value and higher blood pressure compared to patients without PCa (p < 0.001). 146 of 416 (35.0%) patients with MetS had PCa while 124 of 492 (25.2%) patients without MetS had PCa (p < 0.001). Out of 270 patients with PCa, 174 (64.4%) had Gleason score <7 and 96 (35.6%) had Gleason score ≥7. In patients with a Gleason score ≥7, PSA, DRE(+) and core positive number were significantly higher compared to patients with Gleason score <7, while glycemia and high-density lipoprotein (HDL) cholesterol levels were significantly lower (p < 0.001). Multivariate analysis showed that age, PSA, positive DRE, prostate volume (p < 0.001), diastolic blood pressure, CRP and MetS were the only independent parameters associated with a higher risk of cancer on biopsy (p < 0.05).
CONCLUSIONS: Our findings show that MetS is associated with PCa diagnosed on biopsy but not with the Gleason score and the number of cancer-positive cores. However, these results should be confirmed by larger, multicenter and prospective studies.