陰道毛滴蟲感染與侵犯性前列腺癌風險有關


  September 11, 2009 — 根據9月9日美國國家癌症研究院期刊的一篇大型前瞻案例控制研究報告,陰道毛滴蟲感染與侵犯性前列腺癌風險有關。
  
  第一作者、哈佛公共衛生學院的Jennifer R. Stark博士等人在新聞稿中表示,前列腺癌是西方國家男性中最常見的癌症,也是癌症特定死亡率中第二高的原因。確認致命型前列腺癌的可調整風險因素,可提供降低此病之威脅的最大機會。
  
  發表的這篇案例控制研究屬於「Physicians ' Health Study」的一部份,包括了673名前列腺癌患者以及673名有血漿樣本的配對對照組。藉由酵素連結免疫吸附法,研究者檢測在開始時蒐集之血液樣本血漿中的陰道毛滴蟲抗體。以條件式邏輯斯迴歸估計偶發前列腺癌、攝護腺外前列腺癌、導致骨轉移之癌症或前列腺癌相關死亡等的勝算比(ORs)。
  
  陰道毛滴蟲-血清陽性狀態與整體前列腺癌風險之間關聯的重要性,類似於之前的報告,但結果並無統計上的顯著意義(OR,1.23;95%信心區間[CI],0.94 – 1.61)。血清陽性狀態與攝護腺外前列腺癌風險增加 (OR,2.17;95% CI,1.08 – 4.37)、導致骨轉移之癌症或前列腺癌相關死亡(OR,2.69;95% CI,1.37 – 5.28),則均有統計上的顯著關聯。
  
  資深作者、哈佛公共衛生學院的Lorelei Mucci博士表示,事實是,我們發現血清感染陰道毛滴蟲這個可調控的風險因素,與惡化或致命的前列腺癌風險之間的強烈關聯,特別是目前確認的有關侵犯性前列腺癌的風險因素相當少。
  
  研究限制包括,感染與血液樣本的收集期間為何,這可能會影響分析的敏感度;有關逆因果的考量;可能有取樣偏差。
  
  研究作者寫道,這個大型前瞻案例控制研究獲得血清陰道毛滴蟲抗體陽性狀態與前列腺癌風險之關聯的後續支持,統計上之顯著關聯則確認此風險與攝護腺外前列腺癌以及臨床相關、可能致命的前列腺癌之間的關聯。有鑑於對於致命之前列腺癌的相關因素瞭解有限,我們發現陰道毛滴蟲血清狀態和侵犯性前列腺癌之間的關聯是相當值得注意的。如果我們的發現獲得確認,陰道毛滴蟲將可以作為前列腺癌病患不良結果的標記,或者,更理想的話,可以作為二線化學預防之標的。
  
  國家癌症研究中心、國家心肺與血液研究中心、哈佛大學Milton基金會、達那-法柏/哈佛癌症中心前列腺癌研究精進計畫、前列腺癌基金會等支持本研究。
  
  J Natl Cancer Inst. 線上發表於2009年9月9日。
  

T vaginalis Infection Linked to Risk for Aggressive Prostate Cancer

By Laurie Barclay, MD
Medscape Medical News

September 11, 2009 — Trichomonas vaginalis infection is linked to risk for aggressive prostate cancer, according to the results of a large, prospective case-control study reported in the September 9 issue of the Journal of the National Cancer Institute.

"Prostate cancer is the most common cancer among men in western countries, and the second leading cause of cancer-specific mortality," lead author Jennifer R. Stark, ScD, from the Harvard School of Public Health in Boston, Massachusetts, said in a news release. "Identifying modifiable risk factors for the lethal form of prostate cancer offers the greatest opportunity to reduce suffering from this disease."

The present case-control study nested within the Physicians ' Health Study included 673 participants with prostate cancer and 673 individually matched control participants who had plasma samples available for testing. Using an enzyme-linked immunosorbent assay, the investigators tested plasma from blood samples collected at baseline for antibodies against T vaginalis. Odds ratios (ORs) of incident prostate cancer, extraprostatic prostate cancer, and cancer that would ultimately result in bony metastases or prostate cancer–related death were estimated with conditional logistic regression.

The magnitude of the association between T vaginalis–seropositive status and overall prostate cancer risk was similar to that reported previously but was not statistically significant (OR, 1.23; 95% confidence interval [CI], 0.94 – 1.61). Seropositive status was statistically significantly associated with increased risks for extraprostatic prostate cancer (OR, 2.17; 95% CI, 1.08 – 4.37) and for cancer that would ultimately result in bony metastases or death from prostate cancer (OR, 2.69; 95% CI, 1.37 – 5.28).

"The fact that we found a strong association between serologic evidence of infection with Trichomonas vaginalis, a potentially modifiable risk factor, and risk of advanced and lethal disease represents a step forward in prostate cancer, especially given that so few risk factors for aggressive prostate cancer have been identified," said senior author Lorelei Mucci, PhD, also from the Harvard School of Public Health.

Limitations of this study include an unknown period of time between infection and blood collection, which could affect assay sensitivity; concerns regarding reverse causation; and possible detection bias.

"This large prospective case–control study obtained further support for an association between a seropositive status for antibodies against T. vaginalis and the risk of prostate cancer, with statistically significant associations identified for the risk of extraprostatic prostate cancer and for clinically relevant, potentially lethal prostate cancer," the study authors write. "In light of the limited understanding of factors that lead to lethal prostate cancer, our finding of an association between T. vaginalis serostatus and aggressive prostate cancer is noteworthy. If our findings are confirmed, T. vaginalis could serve as a marker for adverse outcomes in patients for prostate cancer or, more optimistically, as a target for secondary chemoprevention."

The National Cancer Institute, National Heart Lung and Blood Institute, Harvard University Milton Fund, Dana-Farber/Harvard Cancer Center Prostate Specialized Program of Research Excellence, and Prostate Cancer Foundation supported this study.

J Natl Cancer Inst. Published online September 9, 2009.

    
相關報導
醫師持續發現PSA檢測的優點
2017/1/3 上午 09:52:51
前列腺癌使用ADT治療會增加失智風險嗎?
2016/11/2 下午 04:54:59
硒、維他命E如何增加前列腺癌風險
2014/3/5 上午 11:33:33

上一頁
   1   2   3   4   5   6   7   8   9   10  




回上一頁