前列腺增生治疗药物对前列腺癌发病率及病理分级的影响

目的 评估前列腺增生治疗药物对前列腺癌发病率及病理分级的影响.方法 回顾性调查1998年2月至2004年12月1029例前列腺增生症患者的药物治疗史,根据药物治疗史将患者分为非那雄胺组、α-受体阻滞剂组、非那雄胺加任一种α-受体阻滞剂联合用药组、对照组(未治疗组)4组.收集4组患者的穿刺病理资料,重新阅读病理片,进行Gleason评分.用Stata 7.0统计软件对4组患者前列腺癌发病率及前列腺癌病理分级差异进行分析.结果 前列腺癌总发病率为13.5%;非那雄胺组、α-受体阻滞剂组、联合治疗组、对照组发病率分别为9.8%、16.0%、10.3%、18.6%;4组间发病率比较应用非那雄胺的丙组与未应用非那雄胺的两组比较差异有统计学意义(P<0.05);前列腺癌患者中病理分级为中高级(Gleason≥7分)的占58.3%,中高分级前列腺癌在4组前列腺癌患者中分别占71.4%、59.6%、67.7%和40.0%.4组间中高分级前列腺癌构成比比较,应用非那雄胺组与未应用非那雄胺组差异有统计学意义(P<0.05).结论 非那雄胺治疗前列腺增生症能降低前列腺癌的发病风险,但同时能使发生的前列腺癌的病理级别增高;α-受体阻滞剂没有类似作用.

The influence of benign prostatic hyperplasia drugs on incidence and pathology grading of prostate cancer

Objective To analyze the influence of benign prostatic hyperplasia ( BPH) drugs on incidence and pathology grading of prostate cancer in China. Methods Retrospectively investigated the history of drug treatment in 1029 cases of BPH in patients from February 1998 to December 2004. According to the history of drug use, the patients were divided into 4 groups: finasteride group, α-receptor inhibitor group, finasteride and α-receptor inhibitor combination group and control group (untreated group). We gathered pathology sections of patients in all groups, and gave Cleason Score to each. The difference of incidence and pathology grading of prostate cancer were analyzed by Stata 7. 0. Results The incidence of prostate cancer in the population of our study was 13. 5% ; The incidence in finasteride group, α-receptor inhibitor group, combination group and control group was 9. 8% , 16. 0% , 10. 3% and 18. 6% , respectively. There was significant difference between the two groups with the use of finasteride and the two groups without it (P <0. 05). In our study, the ratio of middle or high level pathology grading ( Gleason>7) in prostate cancer patients was 58. 3% ,the ratio of middle or high level pathology grading prostate cancer patients in the four groups was 71.4% ,59. 6% ,67. 7% and 40. 0% ,respectively. In the comparison of composition ratio of middle or high level prostate cancer, there was significant difference between the two groups with the use of finasteride and the two groups without it ( P < 0. 05 ). Conclusions Finasteride can lower the risk of prostate cancer, but increase the pathology grade of the prostate cancer which has occurred in the same time. The α-receptor inhibitor does not have the same effect.