CEBP：总胆固醇及甘油三酯水平升高或可增加前列腺癌复发风险

  近日，发表在国际杂志Cancer Epidemiology， Biomarkers & Prevention上的一篇研究论文中，来自杜克大学医学院的研究人员通过研究发现，进行前列腺手术的男性血液中总胆固醇和甘油三酯水平的升高或可增加患者前列腺癌复发的风险。
  Emma Allott博士表示，当前很多研究都揭示了胆固醇在前列腺癌发病中的重要角色，揭示肥胖、胆固醇及前列腺癌之间的关系对于有效控制个体饮食或药物使用来调节胆固醇的水平非常关键，对于后期开发治疗前列腺癌的干预及治疗手段也必不可少。
  本文研究发现，对于血脂异常的男性，如果其血清中脂质水平正常或部分正常则会减少个体前列腺癌复发的风险；文章中研究者对843名进行前列腺切除术的前列腺癌患者进行分析，这些患者都被诊断为前列腺癌且在手术前未服用他汀类药物，研究人员表示，相比正常个体来讲，那些血清甘油三酯大于等于150mg/dL的个体前列腺癌复发的风险会增加35%，在异常血脂水平的患者中（超过200mg/dL），血清胆固醇水平每增加10 mg/dL，前列腺癌复发的风险就增加9%。而对于高密度脂蛋白（好胆固醇）异常的男性来讲，高密度脂蛋白的水平每增加10 mg/dL，前列腺癌复发的风险就会降低39%。
  最后研究人员表示，在843名男性患者中，343名为黑人，325名患者胆固醇水平异常，263名患者甘油三酯水平异常，293名患者病情出现了复发，即在前列腺癌疗法后前列腺特异性抗原（PSA）的水平升高了，这就表明患者的病情出现了复发。（转化医学网360zhyx.com）
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Serum Lipid Profile and Risk of Prostate Cancer Recurrence: Results from the SEARCH Database
Cancer Epidemiology， Biomarkers & Prevention   doi: 10.1158/1055-9965.EPI-14-0458 
Emma H. Allott1,2,3, Lauren E. Howard1,3,4, Matthew R. Cooperberg5, Christopher J. Kane6, William J. Aronson7,8, Martha K. Terris9,10, Christopher L. Amling11, and Stephen J. Freedland1,3,12,* 
Background: Evidence for an association between total cholesterol, low- and high-density lipoproteins (LDL and HDL, respectively), triglycerides, and prostate cancer is conflicting. Given that prostate cancer and dyslipidemia affect large proportions of Western society, understanding these associations has public health importance. 
Methods: We conducted a retrospective cohort analysis of 843 radical prostatectomy (RP) patients who never used statins before surgery within the Shared Equal Access Regional Cancer Hospital (SEARCH) database. Multivariable Cox proportional hazards analysis was used to investigate the association between cholesterol, LDL, HDL, and triglycerides and biochemical recurrence risk. In secondary analysis, we explored these associations in patients with dyslipidemia, defined using National Cholesterol Education Program guidelines. 
Results: Elevated serum triglycerides were associated with increased risk of prostate cancer recurrence [HRper 10 mg/dl, 1.03; 95% confidence interval (CI), 1.01–1.05] but associations between total cholesterol, LDL and HDL, and recurrence risk were null. However, among men with dyslipidemia, each 10 mg/dl increase in cholesterol and HDL was associated with 9% increased recurrence risk (HR, 1.09; 95% CI, 1.01–1.17) and 39% reduced recurrence risk (HR, 0.61; 95% CI, 0.41–0.91), respectively. 
Conclusions: Elevated serum triglycerides were associated with increased risk of prostate cancer recurrence. Cholesterol, LDL, or HDL were not associated with recurrence risk among all men. However, among men with dyslipidemia, elevated cholesterol and HDL levels were associated with increased and decreased risk of recurrence, respectively. 
Impact: These findings, coupled with evidence that statin use is associated with reduced recurrence risk, suggest that lipid levels should be explored as a modifiable risk factor for prostate cancer recurrence. Cancer Epidemiol Biomarkers Prev; 1–8. ©2014 AACR.