Impacts of androgen deprivation therapy on the risks and outcomes of SARS-CoV-2 infection in patients with prostate cancer / 亚洲男科学杂志(英文版)

Studies have investigated the effects of androgen deprivation therapy (ADT) use on the incidence and clinical outcomes of coronavirus disease 2019 (COVID-19); however, the results have been inconsistent. We searched the PubMed, Medline, Cochrane, Scopus, and Web of Science databases from inception to March 2022; 13 studies covering 84 003 prostate cancer (PCa) patients with or without ADT met the eligibility criteria and were included in the meta-analysis. We calculated the pooled risk ratios (RRs) with 95% confidence intervals (CIs) to explore the association between ADT use and the infection risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and severity of COVID-19. After synthesizing the evidence, the pooled RR in the SARS-CoV-2 positive group was equal to 1.17, and the SARS-CoV-2 positive risk in PCa patients using ADT was not significantly different from that in those not using ADT (P = 0.544). Moreover, no significant results concerning the beneficial effect of ADT on the rate of intensive care unit admission (RR = 1.04, P = 0.872) or death risk (RR = 1.23, P = 0.53) were found. However, PCa patients with a history of ADT use had a markedly higher COVID-19 hospitalization rate (RR = 1.31, P = 0.015) than those with no history of ADT use. These findings indicate that ADT use by PCa patients is associated with a high risk of hospitalization during infection with SARS-CoV-2. A large number of high quality studies are needed to confirm these results.

Intraductal Carcinoma of the Prostate Gland: Recent Advances

Intraductal carcinoma of the prostate (IDC-P) is characterized by prostatic carcinoma involving ducts and/or acini. The presence of IDC-P is usually associated with a high-grade Gleason score, large tumor volume, and adverse prognostic parameters, including extraprostatic extension and seminal vesicle invasion. When present, IDC-P is associated with worse outcomes, regardless of treatment status. IDC-P is included in a broader diagnostic category of atypical cribriform lesions of the prostate gland. This category of lesions also includes high-grade prostatic intraepithelial neoplasia (HGPIN), urothelial carcinoma involving prostatic ducts or acini, and prostatic ductal adenocarcinoma, amongst other intraductal proliferations. Differentiating between these entities is important as they have differing therapeutic and prognostic implications for patients, although differential diagnosis thereof is not always straightforward. The present review discusses IDC-P in regards to its morphological characteristics, molecular features, and clinical outcomes. Given the current state of knowledge, the presence of IDC-P should be evaluated and documented correctly in both radical prostatectomy and needle biopsy specimens, and the clinical implications thereof should be taken into consideration during treatment and follow up.

Correlação entre produção agrícola, variáveis clínicas-demográfcas e câncer de próstata: um estudo ecológico / Correlation between agricultural production, clinical and demographic variables and prostate cancer: an ecological study

ResumoFatores de risco para câncer de próstata são pouco conhecidos. O objetivo deste estudo foi explorar correlações entre variáveis relativas à produção agrícola, ao uso de serviços de saúde e sociodemográfcas e às taxas de mortalidade por câncer de próstata entre 2005-2009, nos estados brasileiros. Foi efetuada análise univariada dos dados espaciais para investigação de autocorrelação espacial global das taxas de mortalidade por câncer de próstata nos estados brasileiros entre 2005-2009. Procedeu-se a análise bivariada da correlação entre variáveis sociodemográfcas, de produção agrícola, de utilização de serviços de saúde e de hábitos alimentares e as taxas de mortalidade por câncer de próstata. As produções de soja e milho correlacionaram-se positivamente com mortalidade por câncer de próstata. Na análise de regressão linear espacial múltipla, as variáveis que apresentaram associação com a taxa de mortalidade por câncer de próstata foram toneladas de soja produzidas (p = 0,030), proporção da população com 80 anos e mais (p < 0,001) e consumo de bebidas (p < 0,001). Foi encontrada uma correlação positiva entre toneladas de soja plantada e mortalidade por câncer de próstata. Sendo possível a existência de uma relação entre exposição a agrotóxicos e câncer de próstata.

AbstractRisk factors involved in the etiology of prostate cancer are not well known. The objective of this study was to explore correlations among variables relating to agricultural production, the use of health services, food consumption and socio-demographic characteristics and prostate cancer mortality rates in Brazilian states. Univariate analysis of spatial data for investigation of global spatial autocorrelation in prostate cancer mortality rates in Brazilian states between 2005 and 2009 was conducted. Using bivariate analysis, the correlation between socio-demographic indicators, agricultural production data, variables related to the use of health services dietary intake variables and prostate cancer mortality rates were examined. The production of soybeans and corn were positively correlated with prostate cancer mortality. In multiple linear spatial regression, the variables that showed an association with mortality rates from prostate cancer were tons of soybeans produced (p = 0.030), proportion of the population aged 80 and over (p < 0.001) and consumption of beverages (p < 0.001). A positive correlation between tons of soybeans planted and mortality from prostate cancer was identifed, suggesting the possible existence of an association between exposure to pesticides and prostate cancer.

Avaliação de alterações histopatológicas da próstata e séricas do PSA em ratos tratados com N-Metil-N-Nitrosureia e testosterona / Evaluation of histopathological changes in the prostate and serum PSA in mice treated with N-Methyl-N-Nitrosourea and testosterone

A testosterona tem sido cada vez mais usada em homens na fase do envelhecimento como prevenção e tratamento de doenças metabólicas, melhora do desempenho sexual, proteção cardiovascular e manutenção da cognição. Porém ainda há conflito sobre seus efeitos na próstata com relação às doenças benignas e malignas. O presente estudo avaliou o efeito do tratamento com duas formas de testosterona sobre carcinoma de próstata induzido por N-Metil-N-Nitrosureia (NMU) a partir de análises histopatológicas e séricas do antígeno prostático específico (PSA). Para tal foram utilizados 80 ratos Wistar jovens, sadios, divididos em dois grupos (40 animais cada) tratados ou não com NMU intraperitoneal. Cada grupo foi dividido em quatro subgrupos iguais e tratados durante 16 semanas: 1) tratado com cipionato de testosterona a cada sete dias via intramuscular; 2) tratado com cipionato de testosterona a cada 14 dias via intramuscular; 3) tratado com undecanoato de testosterona oral diariamente; 4) tratado com óleo mineral. Após 16 semanas e tratamento, os níveis do PSA não alteraram em nenhum grupo ou subgrupo e não houve desenvolvimento de tumores em nenhum deles. Portanto, as duas formas distintas de testosterona associada ao uso de NMU em curto espaço de tempo por via intraperitoneal não alteraram as dosagens séricas do PSA e não induziram a formação de tumores na próstata em ratos Wistar jovens e saudáveis. As alterações histopatológicas acinares encontradas nas próstatas foram projeção, secreção, congestão e inflamação, e as epiteliais foram: epitélio normal, redução do epitélio e redução na altura do mesmo. Tais achados colaboram para que outros estudos sejam realizados de maneira a orientar o uso de testosterona na prática clinica diária sem receio de indução do câncer na próstata.

Testosterone has been increasingly used in men during the aging process as prevention and treatment of metabolic diseases, improving sexual performance, cardiovascular protection and maintenance of cognition. But there are still conflicted about its effects in the prostate with respect to benign and malignant diseases. The present study evaluated the effect of treatment with two forms of testosterone on prostate carcinoma induced by N-methyl-N-nitrosourea (NMU) from pathological examinations and serum prostate-specific antigen (PSA). For this we used 80 young Wistar rats, healthy, divides into two groups (40 animals each) or not treated with intraperitoneal NMU. Each group was divided into four equal subgroups and treated for 16 weeks: 1) treated with testosterone cypionate every seven days intramuscularly, 2) treated with testosterone cypionate every 14 days intramuscularly, 3) treated with oral testosterone undecanoate daily, 4) treated with mineral oil. After 16 semanas and treatment, PSA levels did not change in either group or sub-group and no tumor development in any of them. Therefore, two different forms of testosterone associated with the use of NMU in short time intraperitoneally did not affect the serum PSA and did not induce tumor formation in prostate in young healthy rats. Acinar histopathological changes were found in the prostates projection, secretion, congestion and inflammation, epithelial and were normal epithelium, epithelial reduction and reduction in height thereof. These findings collaborate to further studies are performed in order to guide the use of testosterone in daily clinical practice without fear of inducing prostate cancer.