一项最新研究显示，前列腺癌患者出现血管栓塞的风险高于普通人，如果患者接受激素疗法，这种风险会更高。
英国和瑞典研究人员在新一期英国《柳叶刀—肿瘤学》（The Lancet Oncology）杂志上报告说，对瑞典医疗机构记录的7万多名前列腺癌患者的数据分析显示，这些患者出现深静脉血栓和肺栓塞的风险比普通人高。
研究人员介绍说，他们将这些患者分为3组，前两组分别接受过激素疗法和普通手术，还有一组未接受任何治疗。结果发现，所有患者出现血栓的风险都升高，这说明血栓与前列腺癌有关联。
数据还显示，接受激素疗法的患者出现血栓风险最高，他们出现深静脉血栓的风险约是普通人的2.5倍，出现肺栓塞的风险约是普通人的2倍。
研究人员说，接受激素疗法的患者血栓风险高并不意味着要抛弃这种疗法，但这提醒医生，在治疗时应加强血栓监测。
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《柳叶刀—肿瘤学》发表论文摘要（英文）
The Lancet Oncology, Early Online Publication, 14 April 2010doi:10.1016/S1470-2045(10)70038-3Cite or Link Using DOI
Risk of thromboembolic diseases in men with prostate cancer: results from the population-based PCBaSe Sweden
Original TextMieke Van Hemelrijck MSc a , Jan Adolfsson MD b, Hans Garmo PhD a c, Anna Bill-Axelson MD d e, Ola Bratt MD f, Erik Ingelsson MD g, Mats Lambe MD c g, Prof Pär Stattin h, Prof Lars Holmberg MD a c
Summary
Background
Cancer is associated with an increased risk of thromboembolic diseases, but data on the association between prostate cancer and thromboembolic diseases are scarce. We investigated the risk of thromboembolic disease in men with prostate cancer who were receiving endocrine treatment, curative treatment, or surveillance.
Methods
We analysed data from PCBaSe Sweden, a database based on the National Prostate Cancer Register, which covers over 96% of prostate cancer cases in Sweden. Standardised incidence ratios (SIR) of deep-venous thrombosis (DVT), pulmonary embolism, and arterial embolism were calculated by comparing observed and expected (using the total Swedish male population) occurrences of thromboembolic disease, taking into account age, calendar-time, number of thromboembolic diseases, and time since previous thromboembolic disease.
Findings
Between Jan 1, 1997, and Dec 31, 2007, 30 642 men received primary endocrine therapy, 26 432 curative treatment, and 19 526 surveillance. 1881 developed a thromboembolic disease. For men on endocrine therapy, risks for DVT (SIR 248, 95% CI 225—273) and pulmonary embolism (195, 181—215) were increased, although this was not the case for arterial embolism (100, 082—120). Similar patterns were seen for men who received curative treatment (DVT: 173, 147—201; pulmonary embolism: 203, 179—230; arterial embolism: 095, 069—127) and men who were on surveillance (DVT: 127, 108—147; pulmonary embolism: 157, 138—178; arterial embolism: 108, 087—133). Increased risks for thromboembolic disease were maintained when patients were stratified by age and tumour stage.
Interpretation
All men with prostate cancer were at higher risk of thromboembolic diseases, with the highest risk for those on endocrine therapy. Our results indicate that prostate cancer itself, prostate cancer treatments, and selection mechanisms all contribute to increased risk of thromboembolic disease. Thromboembolic disease should be a concern when managing patients with prostate cancer.
Funding
Swedish Research Council, Stockholm Cancer Society, and Cancer Research UK.
