Prostate Cancer: Abstract
Gomarara reprostate (PCa) rinoramba riri iro riri kukonzera kufa kwevanhu muvarume vekuUS uye hutachiwana huri kuramba huchikwira pasi rose kunyanya munyika dzine varume vanodya chikafu che "Western-style". Epidemiologic, preclinical uye kliniki zvidzidzo zvinoratidza basa rinogona kuita rekudya kwekudya pane chiitiko uye kufambira mberi kwePCa. 'Iyi minireview inopa mhedziso yezvinyorwa zvakabudiswa munguva pfupi yapfuura maererano nezvinovaka muviri, zvekudya, maitiro ezvokudya uye PCa chiitiko uye kufambira mberi. Low carbohydrates kudya, soy protein, omega-3 (w-3) mafuta, green teas, tomate uye tomato zvigadzirwa uye zyflamend yakaratidza kuvimbiswa mukuderedza PCa ngozi kana kufambira mberi. Kuwedzerwa kwemafuta akazara uye yakakwirira ?-carotene mamiriro anogona kuwedzera njodzi. Ukama hwechimiro hunogona kuvapo pakati pefolate, vhitamini C, vhitamini D uye calcium ine PCa ngozi. Pasinei nekusawirirana uye kusinganzwisisiki kunowanikwa, mukana wekuita basa rekudya kwekudzivirira uye kurapwa kwePCa iri kuvimbisa. Iko kusanganiswa kwezvinhu zvose zvinobatsira zvePCa kuderedzwa kwengozi muhutano hwehutano hwekudya hunogona kuva mazano ezvokudya zvakanakisisa. Iyi pateni inosanganisira michero yakapfuma nemiriwo, yakaderedzwa yakacheneswa carbohydrates, yakazara uye yakazara mafuta, uye yakaderedzwa nyama yakabikwa. Mimwe miyedzo yakanyatsogadzirirwa inodiwa inodiwa.
Mashoko ekuti: Kudya, Kirasi yeProstate, Nutrients, Dietary pattern, Lifestyle, Kudzivirira, Kurapa, Kudya, Kudya kwezvokudya, Kudzokorora
Mukati
Nhanganyaya: Cancer yaProstate
Kenza yeprostate (PCa) ndiyo yechipiri inowanzosangana nekenza muvarume, uye inenge mamiriyoni mamiriyoni matsva akaonekwa munyika yose gore rimwechete [1], ine makore anenge matanhatu zvakanyanya kuWestern kupfuura munyika dzisiri dzekuMadokero. Zvokudya, mararamiro, zvakatipoteredza uye mazita ezvibhenekeri zvinokonzerwa kuti zvive nechinzvimbo mune kusiyana uku. Ichi chiongorori chinonyanya kufunga nezvehuchapupu huchangobva kuitika hwechinzvimbo chinogona kuitwa chekudya pane PCa uye chinosanganisira epidemiologic uye kuchipatara kuongorora uchapupu hwehuwandu hweproteine, mafuta, makhaidhydrate, fiber, phytochemicals, zvimwe zvikamu zvekudya, zvokudya zvose uye kudya kwemaitiro paPCa chiitiko, kubudirira uye / kana kubudirira. Dhiyabhorosi kubva ku-meta-kuongorora kana maitiro akaitwa nemaitiro randomized uye zvidzidzo zvinotarisirwa zvinosimbiswa munyaya ino. Zvinofanira kuonekwa kuti zvidzidzo zvekudya kana kudya kunovaka muviri uye kenza zvinowanzotarisana nezvisungo zvakasiyana-siyana uye zvinoshandura kududzira zvido. Somuenzaniso, kana chidzidzo chakagadzirirwa kuongorora kushanda kwehuwandu hwemafuta, kuchinjwa kwemafuta kunowedzera kushandura kudya kweproteine uye / kana kinehydrates, uye kunogona kuchinja kudya kwevamwe michina pamwe chete. Somugumisiro, zvakaoma kutaura kuti kuchinja kuchinja mumafuta kunodya chete. Mukuwedzera, zvinokonzera macronutrients zvinogona kusanganisira zvikamu zvezvose zvakakwana uye rudzi rwe macronutrients dzinoshandiswa. Zvose izvi zvinogona kukanganisa kenza yekutanga uye / kana kubudirira pasina, asi haisi nguva dzose kusiyanisa mukutsvakurudza maitiro. Kunyange zvazvo nyaya iyi ichangobva kuongororwa [2], ichipa mabhuku matsva akawanda pamusoro pehurukuro, kuongororwa patsva kunoratidzwa pano uye pfupikiso tafura inopiwa nezvekutsvaga (Table 1).
Nutrients Carbohydrates Zvichipa pfungwa yokuti insulini inokonzera kukura kwePCa, yave ichifungidzirwa kuti kuderedza makhahydrates uye nokudaro kuderedza serum insulin inogona kuderedza PCa kukura [3]. Zvechokwadi, mumhando dzemhuka, ingave isina-carbohydrate ketogenic diet (NCKD) [4,5] kana kudya kwakaderera-carbohydrate (20% kcal semakhahydrates) kune migumisiro yakanaka pakuderedza kukura kwechirwere cheprostate [6,7]. Muzvidzidzo zvevanhu, chidzidzo chimwe chakawana kuti kudya kwakanyanya kwemakhahydrates akacheneswa kwakabatanidzwa nehuwandu hwengozi yePCa [7]. Mukuwedzera kune huwandu hwemakhahydrates, rudzi rwemakhahydrates runogona kukanganisa paPCa asi tsvakurudzo yave isina kukwana. Iyo inogona kuderedza PCa njodzi uye kufambira mberi kuburikidza nekukanganisa carbohydrate metabolism iri kushingaira kuongororwa neMetformin. Metformin yakaderedza PCa cell proliferation uye kunonoka kufambira mberi mu vitro uye mu vivo, maererano [8-10] uye kuderedza ngozi yezviitiko uye kufa kwevanhu [11-13]. Miedzo miviri yemakiriniki yemaoko maviri yakaratidzawo maitiro akanaka emetformin mukukanganisa zviratidzo zvePCa kuwedzera uye kufambira mberi [14,15]. Zvisinei, zvimwe zvidzidzo zvekare zvekare hazvina kutsigira chiitiko che metformin pakudzoka kana chiitiko chechiitiko chePCa [16-22]. Pasinei nekukwanisa kuderedza chero makhahydrates akazara kana akareruka mukubatsira PCa control, uchapupu hunoshaikwa kubva kune randomized controlled trials (RCT). Miedzo miviri yakarongeka iri kuenderera mberi ichiongorora kukanganisa kwekudya kwakaderera-carbohydrate (inenge 5% kcal) paPSA kaviri nguva pakati pevarwere vePCa post radical prostatectomy (NCT01763944) uye pamhinduro yeglycemic pakati pevarwere vanotanga androgen deprivation therapy (ADT) ( NCT00932672 ). Zvakawanikwa kubva mumiedzo iyi zvichajekesa mhedzisiro yekabhohaidhiretsi kudya pane mamakisi ePCa kufambira mberi uye basa rekuderedzwa kwekabhohaidhiretsi kudya pakugadzirisa mhedzisiro yeADT.
Protein
Iyo yakakwana yeprotheni inotora hutano hwakakwana hutano kana prostate hutano husina kujeka. Pasinei nekufarirwa kwezvishoma zvekudya kwemakinehydrates zvakakosha mumapurotini, zvidzidzo zvevanhu zvenguva ichangopfuura zvakashuma kuti kuderera kweprotini kudya kwakabatanidzwa nehutano huripo hwekenza uye nekufa kwevanhu pakati pevarume 65 uye vaduku. Pakati pevarume vakakura kudarika 65, kudya kwepuroteni yakaderera kwakabatanidzwa nehuwandu hwehutano hwekenza nekufa kwevanhu vose [23]. Mune mhuka yemhando iyo kuwirirana pakati peprotheni neakagidhyidrate yakagadziriswa nehutano hwemaridhiometabolic, kukwegura uye kurarama kwenguva refu [24]. Basa reprotheni yezvokudya uye mapuroteni kusvika kumahydrohydrate chiyero paPca kukura nekufambira mberi kunoda kudzidza zvakanyanya.
Animal-Based Proteins
Kudzidza mapuroteni kudya, kufanana nezvose zvesayenzi yezvokudya, zvinogona kunge zvakaoma. Semuenzaniso, nyama yemhuka, iyo inotora mapuroteni muMadokero kudya, inoumbwa kwete chete yeproteiniti, asiwo yeaforo, cholesterol, mineral uye nezvimwewo zvinovaka muviri. Kuwanda kwezvibereko izvi zvinosanganisira mafuta acids zvinogona kusiyana kubva kune imwe nyama yemhuka kune imwe. Ongororo dzakapfuura mumunhu dzakaratidza kuti kushandiswa kwemhou dzisina ganda, iyo yakaderera mucholesterol nemafuta akazara kupfuura dzakawanda zvekudya zvitsvuku, haina kubatana nekudzoka kana kufambira mberi kweCaPa [25]. Zvisinei, kushandiswa kwemhuka yehuku yakabikwa kwaipindirana nePaca yakakurumbira [26,27], iyo nyama yakatsvuka yakagadzirwa nekawanda yakakura PCa ngozi [26,27]. Nokudaro, kuti zvokudya zvakagadzirirwa sei zvingashandura kukanganisa kwayo paPCa ngozi nekufambira mberi. Kakawanda, hove inoshandiswa inogona kuenzaniswa neAccc mortal mortality, asi yakakwirira yehove yakagadzirwa inogona kuunza PCa carcinogenesis [28]. Nokudaro, zvinogona kukurudzirwa kudya hove nguva dzose asi kubika kusimba kunofanira kuchengetedzwa.
Dairy-Based Protein
Imwe proteiniti inowanzo inogadzirwa nemishonga, yakadai semukaka, tese uye yogurt. Ongororo dzakapfuura dzakaratidza kuti dairy yakawedzera huwandu hweCaida asi kwete neCPP ine utsinye kana kuti inouraya [29,30]. Mukuwedzera, mukaka wose uye yakaderera-mukaka kushandiswa kwemukaka zvakashumirwa kune kana kukurudzira kana kunonoka PCa kufambira mberi [29,31]. Mu Physicians Health rinotevera boka revarume nevarume ve21,660, huwandu hwese hwekushandisa hwaiwanika hunobatanidzwa nekuwedzera kweCaidha [32]. Kunyanya, mafuta akaderera kana mukaka wakawanda wakaderera pasi grade PCa, asi mukaka wose wakanyanya kuuraya PCa ngozi. Kunyange zvazvo chaiwo zvikamu (s) zvemishonga yemiti inotyaira masangano aya hazvizivikanwi, kuwedzera kwemafuta ane mafuta uye calcium inogona kunge yakabatanidzwa. Chidzidzo chemuchinjikwa chevarume ve1798 chakaratidza kuti mapuroteni emakaka aive akanaka achibatanidzwa ne serum IGF-1 [33] mazinga anogona kukurudzira kutanga kana kufambira mberi kweCaPa. Nokudaro, kutsvakurudza kwakawedzerwa kunofanirwa kujekesa ukama huri pakati pekudya kwehairy na PCa. Pane nharo yakakwana yekupa mazano anokurudzirwa zvakananga nemapuroteni emishonga kana dairy uye PCa ngozi kana kufambira mberi.
Plant-Based Proteins
Soy uye soy-based products zvakapfuma muprotein uye phytoestrogens inogona kufambisa PCa kudzivirira, asi basa rayo paPCa harina kujeka. Muchidzidzo mumakonzo, kudya kwemishonga ye soya kwakabatanidzwa nekuderera kwehepatic aromatase, 5?-reductase, kutaura kwe androgen receptor uye majini ayo anogadziriswa, FOXA1, urogenital tract weight uye PCa tumor progression [34]. Chiyedzo chechangobva kuitika chevarume ve177 vane chirwere chepamusoro-soro mushure mekuita prostatectomy yakawana kuti soy protein supplementation kwemakore maviri yakanga isina kukanganisa panjodzi yePCa kudzokorora [35]. Kunyange zvazvo epidemiological and pre-clinical studies [36,37] inotsigira basa rinogona kuita soy / soy isoflavones muPCa kuderedza ngozi kana kufambira mberi, meta-analysis haina kuwana kukanganisa kukuru kwekudya kwe soy muPSA mazinga, hormone-binding globulin, testosterone, testosterone yakasununguka, estradiol kana dihydrotestosterone [38]. Imwe RCT muvarwere vasati vaita prostatectomy zvakare haina kuwana chero mhedzisiro ye soy isoflavone yekuwedzera kusvika kumavhiki matanhatu paPSA, serum yakazara testosterone, yemahara testosterone, yakazara estrogen, estradiol kana yakazara cholesterol [39]. Sezvo mazhinji eRCTs akaitwa anga ari madiki uye enguva pfupi, kumwe kuongorora kunodiwa.
Ongororo dzakawanda dzakaramba dzichinyatsoongorora isoflavone inokosha mune soy, genistein, uye zvayo paCaPa. Izvo zvinoita kuti genistein irege kubvisa PCa cell detachment, kupinda uye metastasis inonzi [40]. Genistein inogona kugadzirisa glucose update uye glucose transporter (GLUT) kutaura mu PCa masero [41], kana kushandisa simba rayo rinopesana nemarara kuburikidza nekuraira ma microRNAs akawanda [42]. Zvidzidzo zvinoshandisa masero masero uye mhuka zvinoratidza kuti genistein inogona kukwikwidzana nekuvhara isrogens inogadzikana kubva pakisungwa kune estergen receptor, nokudaro inhibisa kupararira kwemasero, kukura, uye kukonzera kusiyanisa uye, kunyanya, genistein inogona kudzivirira kushandiswa kwema cell, protease production, kushandiswa kwemasero uye saizvozvo kudzivirira metastasis [36,40,43]. Zvisinei, hapana plasma kana urinary genistein maitiro akabatanidzwa neCaa ngozi kana zviitiko zvekuongorora [44,45]. Muchikamu che 2-controlled controlled RCT ne47 varume, kuwedzera kwe 30 mg genistein kwemavhiki matatu kusvika matanhatu zvakaderedza zvakanyanya zviratidzo zve-PCa zvinokonzerwa nerorogen [46]. Mukuwedzera, genistein inogona kubatsira mukuvandudza cabazitaxel chemotherapy mune metastatic castration-resistant PCa [37]. Zvidzidzo zvekliniki zvakabvumirwa kupfuurira mberi kuongorora basa re soy uye soy isoflavones yePCa kudzivirira kana kurapwa. A definitive recommendation pamusoro peprotini yekudya kwePaP kudzivirira kana kurapwa hakuwanikwi zvakadaro.
mafuta
Tsvagiridzo yekuongorora kuongorora kushandiswa kwemafuta nePCa njodzi kana kufambira mberi kunopesana. Zvose zvinokwana zvakakwana [47] zvemafuta ezvokudya uye hukama hwemafuta acid hunogona kuzvimiririra hunoenderana nePCa kutanga uye / kana kufambira mberi. Kunyange zvazvo zvidzidzo zvemhuka zvichiramba zvichiratidza kuti kuderedza kudya kwemafuta kunoderedza kukura kwechirwere [48-50] uye kudya kwemafuta akawanda, kunyanya mafuta emhuka nemafuta ezviyo zvinowedzera PCa kufambira mberi [51], data yevanhu haina kuwirirana. Nyaya yekuongorora zvidzidzo uye zvidzidzo zveboka zvakaratidza kuti hapana kushamwaridzana pakati pekushandiswa kwemafuta uye PCa ngozi [52-55] kana kushamwaridzana kwakasiyana pakati pemafuta ekudya uye PCa kupona, kunyanya pakati pevarume vane PCa [47]. Mukuwedzera, chidzidzo chemuchinjikwa chakaratidza kuti kudya kwemafuta kunoratidzwa sezana muzana yehuwandu hwekoriori yekudya kwakanyatsobatanidzwa nePSA mazinga muvarume ve13,594 vasina PCa [56]. Zvichipa idzi data dzinopesana, zvinokwanisika kuti rudzi rwemafuta acid [56] panzvimbo pehuwandu hwehuwandu hunogona kuita basa rinokosha muPCa kukura nekufambira mberi. Chidzidzo chakawana plasma yakazara mafuta acids kuti ive yakanaka yakabatana nePCa ngozi mune vanotarisira boka revarume ve14,514 veMelbourne Collaborative Cohort Study [57]. Mukuwedzera, imwe tsvakurudzo yakawana kuti kudya mamwe mafuta-based fat kwakabatanidzwa nekuderedza PCa ngozi [58]. Zvidzidzo izvi zvinotsigira nhungamiro yezvino yekudya yekudya mafuta mashoma-anobva kumhuka uye mamwe mafuta ezvirimwa.
Iyo data ine chekuita ne omega-6 (w-6) uye omega-3 (w-3) polyunsaturated fatty acid (PUFA) kushandiswa uye PCa ngozi iri kupokana. Kunyange paine data rekutsigira chinongedzo pakati pekuwedzera w-6 PUFA yekudyiwa (kunyanya inotorwa kubva kumafuta echibage) uye njodzi yePCa yakazara [57,59], kwete data rese rinotsigira chinongedzo chakadai [60]. Ichokwadi, yakawanda polyunsaturated mafuta kudya kwaibatanidzwa nechepasi zvose zvinokonzera kufa pakati pevarume vane nonmetastatic PCa mu Health Professionals Follow-up study [58]. Iyo yakatemwa nzira inobatanidza w-6 PUFAs uye PCa njodzi ndiko kushandurwa kwe arachidonic acid (w-6 PUFA) kune eicosanoids (prostaglandin E-2, hydroxyeicosatetraenoic acids uye epoxyeicosatrienoic acids) inotungamira mukuzvimba uye kukura kwemaseru [61]. Ukuwo, w-3 PUFAs, ayo anowanikwa kunyanya mumvura inotonhorera hove ine mafuta, inogona kunonoka kukura kwePCa kuburikidza nenzira dzinoverengeka [61-63]. Mune ongororo yevarume makumi mana nemasere vane njodzi yakadzika PCa vari pasi pekuongororwa kwakasimba, dzokorora bhaopsy mumwedzi mitanhatu yakaratidza kuti nyama yeprostate w-48 fatty acids, kunyanya eicosapentaenoic acid (EPA), inogona kudzivirira pakurwisa PCa kufambira mberi [3]. In vitro uye zvidzidzo zvemhuka zvinoratidza kuti w-64 PUFAs inokonzera anti-kupisa, pro-apoptotic, antiproliferative uye anti-angiogenic nzira [3]. Zvakare, chidzidzo chegonzo chichienzanisa mhando dzakasiyana dzemafuta chakawana kuti chete hove yemafuta yekudya (ndokuti, omega-65,66 based diet) yakadzora kukura kwePCa zvinoenderana nemamwe mafuta ekudya [3]. Panyaya yedata revanhu, chikamu chechipiri cheyakaedzwa chiedzo chakaratidza kuti kudya kwakaderera-mafuta ne w-67 yekuwedzera masvondo mana kusvika matanhatu pasati radhesa prostatectomy yakadzikira kuwanda kwePCa uye kufambira mberi kwesero (CCP) [3]. Kudya kwemafuta ehove yakaderera-mafuta kwakakonzera kuderera kwe62,68 (S) - hydroxyeicosatetraenoic acid mazinga uye yakadzora mamaki eCCP zvine chekuita nekudya kwekuMadokero [15]. Izvo zvinogona kubatsira zve omega-69 fatty acids kubva kuhove zvinotsigirwa nemapidemiological mabhuku anoratidza kuti w-3 fatty acid yekudyiwa yaive inopesana neyakauraya PCa ngozi [3]. Zvisinei nevimbiso ye omega-70,71 fatty acids, hadzisi dzese zvidzidzo dzinobvumirana. Kuwedzera 3 g alpha-linolenic acid (ALA) pazuva kwemwedzi makumi mana mu2 varume vane PSA <40 ng / ml havana kuchinja PSA yavo [1,622]. Zvisinei, kumwe kuongorora kwakawana kuti serum yakakwira yeropa n-4 PUFA uye docosapentaenoic acid (DPA) yaibatanidzwa nekuderedzwa kwese PCa ngozi nepo serum yakakura EPA uye docosahexaenoic acid (DHA) ingangodaro yaibatanidzwa nekuwedzera kwepamusoro-grade PCa ngozi [72] . Kuwedzera kutsvagurudza kunodiwa kuti unzwisise zvirinani iro basa re omega-3 PUFAs muPCa kudzivirira kana kurapwa.
Cholesterol
Zvidzidzo zvakawanda zvekare zvisati zvaitika zvakaratidza kuti kuunganidza kweklesterolori kunobatsira pakufambira kwe PCa [74-76]. Yakave yakarongedzwa kuti cholesterol yakakura muLin et al. BMC Medicine (2015) 13: 3 Page 5 yekupararira kwe15 inogona kuva chikonzero chekutengesa mishonga yakasimba, kunyanya kuburikidza nokukwirirwa kwecholesterol, nzira dzinopisa [77] uye intratumoral steroidogenesis [78]. Maererano nekuongorora kwechangobva kuitika nevarume ve2,408 vakarongerwa kuti vashandise biopsy, serum cholesterol yakanga yakazvibatanidza nekufanotaura kweCaa risk [79]. Zvinopesana nezvakawanikwa necholesterol, kushandiswa kwecholesterol kuderedza mishonga yemishonga post radical prostatectomy (RP) yakanyatsobatanidzwa nehuwandu hunopedzisira hwekudzoka kwehupenyu mu1,146 radical prostatectomy patients [80]. Imwe yedzidzo yakaratidzawo kuti mitemo inogona kuderedza PCa ngozi kuburikidza nekuderedza kufambira mberi [81]. Kunyange zvazvo michina isati yasimbiswa, zvidzidzo zvitsvakurudzo zvekare zvakaratidzawo kuti iyo yakaderera yepamusoro-density lipoprotein (HDL) yekolestol yepamusoro yakabatanidzwa nehuwandu hwakawanda hwePaP uye, nokudaro, yakakwirira HDL yaiva yezvidziviriro [81-84]. Izvi zvakawanikwa zvinotsigira pfungwa yokuti kupindira kwemwoyo-ine utano hunoita kuti kuderedza cholesterol kunogona kubatsira mararamiro eprostate zvakare.
Vhitamini & Zvicherwa
Pano tichaongorora data razvino revhitamini A, B yakaoma, C, D, E, uye K uye selenium. Mumakiriniki maviri makuru ekuedzwa: iyo Carotene uye Retinol Efficacy Trial (CARET; PCa yaive yechipiri mhedzisiro) uye National Institutes of Health-American Association of Retired Persons (NIH-AARP) Diet uye Hutano inotarisirwa cohort kudzidza, yakawandisa multivitamin supplementation yaive. inobatanidzwa nehuwandu hwepamusoro hwekugadzira PCa ine utsinye, kunyanya pakati pevaya vanotora mumwe munhu?-carotene zvinowedzera [85,86]. Saizvozvowo, high serum ?-carotene mazinga akabatanidzwa nehuwandu hwehutano hwePCa pakati pevarume ve997 Finnish muKuopio Ischemic Heart Disease Risk Factor cohort [87]. Zvisinei, ?-carotene supplement haina kuwanikwa inokanganisa ngozi yePCa inouraya panguva yekurapa [88], kana muDanish inotarisira cohort kudzidza yevarume ve26,856 [89]. Kutenderera retinol zvakare kwakanga kusina kubatanidzwa nePCa ngozi mune imwe nyaya huru-control study [90]. Nokudaro, kushamwaridzana pakati pevhitamini A nePCa kuchiri kujeka.
Preclinical humbowo hunoratidza kuti folate depletion inogona kunonoka bundu kukura, nepo supplementation haina mhedzisiro pakukura kana kufambira mberi, asi inogona kutungamirira zvakananga ku epigenetic shanduko kuburikidza nekuwedzera muDNA methylation [91]. Meta-analysis mbiri yakaratidzawo kuti kutenderera kwefolate mazinga akabatanidzwa zvakanaka nehuwandu hwehuwandu hwePCa [92,93], nepo kudya kana kuwedzera folate yakanga isina simba paPCa ngozi [94] muboka rekudzidza nevarume ve58,279 muNetherlands [ 95] uye chidzidzo chekutonga muItaly neSwitzerland [96]. Muchokwadi, kumwe kuongorora kweboka revarume vari kuita radical prostatectomy munzvimbo dzinoverengeka dzeVeterans Administration mhiri kweUS kwakaratidza kuti yakakwirira serum folate mazinga aibatanidzwa nePSA yakaderera uye, nekudaro, njodzi yakaderera yekukundikana kwebiochemical [97]. Imwe ongororo inoshandisa data kubva ku2007 kusvika 2010 National Health uye udyo Ongororo Yokuongorora yakaratidza kuti chimiro chepamusoro chevanhu chinogona kudzivirira pamasero akakwirira ePSA pakati pevarume ve3,293, 40-yemakore nemakore, vasingawaniki PCa [98]. Yakave yakarongerwa kuti folate inogona kuita nhengo mbiri mu prostate carcinogenesis uye, saka, hukama hwakakomba pakati pe folate naPCa hunomirira kupfuurira mberi [99].
Pasinei nebasa rinogona kuita vitamini C (ascorbic acid) se antioxidant muanticancer therapy, miedzo yekuongorora kudya kana kuwedzera kwevhitamini C inokosha. RCT haina kuratidza kushanda kwevhitamini C kudya paPaa ngozi [89]. Uyezve, vitamini C pamvura yakakwirira inogona kuita zvakanyanya sepro-oxidant kupfuura antioxidant, kuomesa tsvakurudzo yekugadzira uye kududzira.
Iyo yekutanga inoshanda fomu yevhitamini D, 1,25 dihydroxyvitamin D3 (calcitriol) inobatsira mukuumbwa kwakakodzera kwepfupa, inokonzera kusiyanisa kwemamwe masero emuviri, uye inhibits pro-tumor nzira, dzakadai sekuwedzera uye angiogenesis, uye yakanzi inobatsira PCa ngozi. [100]; zvisinei, zvakawanwa zvinoramba zvisina mufungo. Zvimwe zvidzidzo zvenguva pfupi zvakawana kuti kuwedzera serum vitamin D mazinga akabatanidzwa nekuderera kwePCa ngozi [101,102]. Uyezve, kuwedzera vitamini D kunogona kuderedza PCa kufambira mberi kana kukonzera apoptosis muPCa masero [103-105]. Zvimwe zvidzidzo, zvisinei, zvakashuma kana kusakanganiswa kwevhitamini D kuwedzera paPSA [106] kana kuti hapana mhedzisiro yevhitamini D mamiriro paPCa njodzi [107,108]. Zvimwe zvidzidzo zvinopesana zvakarondedzera kuti chimiro chezasi chevhitamini D chakabatanidzwa nechepasi PCa ngozi kune varume vakuru [109], kana serum vitamin D yakakwirira yakabatanidzwa nepamusoro PCa ngozi [110,111]. Chidzidzo chakatoratidza kuti hukama hwe "U" hunogona kuvapo pakati pevhitamini D mamiriro uye PCa uye huwandu hwakakwana hwekutenderera kwevhitamini D yekudzivirira kwePCa inogona kunge yakamanikana [112]. Izvi zvinoenderana nezvakawanikwa kune zvimwe zvinovaka muviri kuti kudya kukuru kwekudya kunovaka muviri kunogona kusagara kuri nani.
Ongororo yechangobva kuonekwa yakaratidza kuti kusangana pakati pevhitamin D neCaPa kwakagadziridzwa neprotini D-binding protein [113] iyo inogona kunge yakatsanangura zvishoma zvisati zvaitika. Uyezve, kuongorora meta kunoongorora sangano pakati peVitamin D receptor (VDR) mapuroymorphisms (BsmI naFokI) uye PCa ngozi yakashuma pasina ukama neCaa risk [114]. Nokudaro, basa re vitamini D muCaC rinoramba risina kujeka.
Muchiyedzo chakakura chisina kujairika nehwerengedzo ye14,641 US varapi vechirume ?50-yemakore, vatori vechikamu vakagamuchira 400 IU yevhitamini E rimwe zuva rimwe nerimwe rehuwandu hwe10.3 (13.8) makore. Vitamin E yekuwedzera yakanga isina mhedzisiro kana yenguva refu panjodzi yekenza yakazara kana PCa [115]. Zvisinei, chiyero chepakati chevhitamini E chinowedzera (50 mg kana nezve 75 IU) chakakonzera kuderera kwePCa ngozi pakati pe29,133 Finnish varume vanoputa [116]. Ongororo dzakawanda dzepreclinical dzinoratidza kuti vhitamini E inononoka bundu kukura, pamwe nekuda kwekuvharidzira DNA synthesis uye inducing "apoptotic nzira [117]. Zvinosuruvarisa, zvidzidzo zvevanhu zvave zvishoma pane zvinotsigira. Zvidzidzo zviviri zvekucherechedza (Cancer Prevention Study II Nutrition Cohort uye NIH-AARP Diet uye Health Study) zvose zvakaratidza kushamwaridzana pakati pevhitamini E kuwedzera uye PCa ngozi [118,119]. Zvisinei, serum yakakwirira ?-tocopherol asi kwete ?-tocopherol level yakabatanidzwa nekuderera kwengozi yePCa [120,121] uye kushamwaridzana kunogona kuchinjwa nekusiyana kwemajini mu vitamin E ane chokuita nemajini [122]. Pane zvinopesana, imwe nzira inotarisirwa kuongororwa, Selenium uye Vitamin E Cancer Prevention Trial (SELECT), yakaratidza vitamin E kuwedzera zvakanyanya kuwedzera PCa ngozi [123] uye kuti plasma yakakwirira? PCa ngozi [124]. Izvi zvinowirirana ne-case-cohort yekuongorora nyaya dze1,739 uye kutonga kwe3,117 kwakaratidza vitamin E yakawedzera PCa ngozi pakati pevaya vane chimiro chakaderera che selenium asi kwete avo vane high selenium status [125]. Nokudaro, kutsvakurudza kwakawanda kunodiwa kuti uongorore kushamwaridzana pakati pevhitamini E nePCa uye mhedzisiro yedosi uye kuwirirana nezvimwe zvinovaka muviri zvinofanira kufungwa.
Vitamin K yave ichifungidzirwa kubatsira kudzivirira PCa nekudzikisa bioavailable calcium. Zvidzidzo zvepreclinical zvinoratidza kusanganiswa kwevhitamini C uye K vane simba rekuita antitumor mu vitro uye kuita se chemo- uye radiosensitizers mu vivo [126]. Kusvika iye zvino, zvidzidzo zvishomanana zvakatsvaga izvi, kunyange zvazvo imwe tsvakurudzo inoshandisa European Prospective Investigation muCancer uye Nutrition (EPIC) -Heidelberg cohort yakawana hukama hwakasiyana pakati pevhitamini K (se menaquinones) kudya uye PCa chiitiko [127]. Zvishoma kana zvisina preclinical zvidzidzo zvakaitwa kuti zviongorore basa re calcium nePCa. Retrospective uye meta-analysis inoratidza kuwedzera kana kuderedzwa kwePCa ngozi nekuwedzera calcium kudya, asi vamwe vanoratidza kuti hapana kushamwaridzana [128,129]. Chimwe chidzidzo chinoratidza kushamwaridzana kwakafanana neU, uko kwakaderera zvikuru calcium mazinga kana supplementation zvose zvinosanganiswa nePCa [130].
Selenium, kune rumwe rutivi, yakafungidzirwa kudzivirira PCa. Kunyange zvazvo in vitro zvidzidzo zvakaratidza kuti selenium inhibited angiogenesis uye kupararira apo ichiita kuti apoptosis [131], zvigumisiro kubva kuSELECT zvakaratidza kusabatsirika kweselenium chete kana kusanganiswa ne vitamin E yePCa chemoprevention [123]. Uyezve, selenium supplementation haina kubatsira varume vane chimiro chakaderera che selenium asi yakawedzera dambudziko repamusoro-grade PCa pakati pevarume vane selenium yakakwirira mune imwe nzvimbo yakasarudzwa yakasarudzwa yezviitiko zve1,739 nepamusoro-grade (Gleason 7�10) PCa uye 3,117 kutonga [ 125]. Mumwe anotarisira Netherlands Cohort Study, iyo yaisanganisira varume ve58,279, 55- kusvika ku69-yemakore, yakaratidzawo kuti toenail selenium yakabatanidzwa nengozi yakaderedzwa yePCa [132]. Kumwe kutsvakurudza kunodiwa kujekesa basa re selenium nePCa.
Phytochemicals
Pamwe pamwe nemavitamini nemaminerari [2], zvinomera zvine phytochemicals zvinogona kupesana nekenza zvinokonzera. Kazhinji isingafungi makemikari anokosha, phytochemicals ane antioxidant uye anti-inflammatory properties.
Silibinin inonzi polyphenolic flavonoid inowanikwa mumhodzi dzemukaka rukato. Yakaratidzwa mu vitro uye in vivo inhihit PCa kukura nekutsvaga epidermal growth factor receptor (EGFR), IGF-1 receptor (IGF-1R), uye nuclear factor-kappa B (NF-kB) nzira [133,134]. Ongororo ichangobva kuitika yakaratidza kuti silibinin inogona kubatsira mukudzivirira kwePCa nekudzivisa TGF?2 kutaura uye cancerassociated fibroblast (CAF)-senge biomarkers mumasero emunhu prostate stromal [135]. Nekudaro, silibinin mumiriri anovimbisa sePCa chemopreventive agent inomirira kumwe kutsvagisa.
Curcumin inoshandiswa sechikafu chekuwedzera muAsia uye semishonga yemakwenzi yekuzvimba [136]. In vitro, curcumin inhibits pro-inflammatory protein NF-?B apo inokonzera apoptosis kuburikidza nekuwedzera kwekutaura kweproapoptotic gene [137]. Mu vivo, curcumin inononoka PCa kukura mumakonzo apo ichikurudzira tumarara kune chemo- uye radiotherapies [136]; zvisinei, hapana kuedza kwevanhu kwakaongorora maitiro ayo paPCa.
mutamba
Ikoko uye michero yemapomegranati nemadnuts zvakapfuma muellagitannins (punicalagins). Izvo zviputikemikemu zvinoshandiswa nyore nyore kugadzirisa mafomu eallagic acid nemvura inopisa [138]. Zviratidzo zvepakutanga zvinoratidza ellagitannins inhibit PCa kupararira uye angiogenesis pasi pehana hypoxic uye zvinokurudzira apoptosis [137,138]. Mune zvinotarisirwa mumiriri kune varume vane PSA inokura mushure mekutanga kurapwa, pomegranate juice kana POMx, kubviswa kwepomegranate inowanikwa mune zvekutengeserana, yakawedzera nguva yePSA yekupeta kaviri maererano nechekutanga [139,140], kunyange zvazvo pasina miedzo yaisanganisira boka re placebo. Migumisiro iri kumirira kubva kune imwe nzvimbo inotarisira nzvimbo iyo RCT uchishandura pomegranate muvarume vane PSA inokura. Zvisinei, muedzo wepa placebo inotungamirirwa, mapiritsi maviri ePOMx zuva rega kwemavhiki mana asati aita hutachiona hwe prostatectomy ainge asina kukonzera kuora kwemararamiro kana kushungurudzika kweiyo oxidative kana chero imwe mimwe miviri inoshandisa [141].
Green Tea
Green tea ine akati wandei e antioxidant polyphenols anosanganisira makatechini, akadai epigallocatechin gallate (EGCG), epigallocatechin (EGC), (?) -epicatechin-3-gallate (ECG) uye (?) -epicatechin. Zvidzidzo zvepreclinical zvinoratidza EGCG inhibits PCa kukura, induces intrinsic uye extrinsic apoptotic nzira uye inoderedza kuzvimba nekudzivisa NFkB [137]. Uyezve, iyo antioxidant properties yeEGCG ndeye 25 kusvika ku100 nguva yakawanda kupfuura mavitamini C uye E [131]. Mune inotarisirwa randomized preprostatectomy muedzo, varume vanodya yakabikwa yegirini tii Lin et al. BMC Medicine (2015) 13: 3 Peji 7 ye15 isati yavhiyiwa yakanga yawedzera mazinga egirinhi tii polyphenols mu prostate tissue [142]. Muchipupuriro chiduku-chemitemo yekuedza nevarume ve60, kuwedzera kwezuva nezuva kwe600 mg green tea catechin extract yakaderedza PCa chiitiko ne90% (3% inopesana ne30% muboka re placebo) [143]. Imwe muedzo muduku yakaratidzawo kuti EGCG yekuwedzera yakaguma nekuderedza kukuru kwePSA, hepatocyte kukura chinhu uye vascular endothelial growth factor muvarume vane PCa [144]. Izvi zvidzidzo zvinoratidza green tea polyphenols inogona kuderedza PCa chiitiko uye kuderedza PCa kufambira mberi asi tsvakurudzo yakawanda inodiwa kusimbisa uye kujekesa nzira yayo [137,143,145].
Resveratrol
Kunyange zvazvo vakawanda vari mu-in vitro vachiratidza kuti resveratrol inhibits PCa kukura [146-148], resveratrol inoderedza chiremera chekukura mune zvimwe [137] asi kwete mhuka dzose dzinofanirwa [149], zvichida nemhaka yehuwandu hwehuwandu hwehuwandu hwe [150,151]. Kusvika parizvino, hapana kliniki yekuedza kutsvaga nzira dzekudzivirira kana dzokurapa dze resveratrol pa PCa.
Zyflamend
Zyflamend isanganisi inopesana nekuputira ye herbs yakaratidzwa kuderedza PCa kufambira mberi nekuderedza kushandiswa kwema marker kusanganisira pAKT, PSA, histone deacetylases uye receptor ye-androgen mumhando dzemhuka uye PCa cell line [152-154]. Pasinei nehuwandu hunopesana nekenza [155], zvishomanana zvidzidzo zvakaitwa nevanhu [156,157]. Muvharo rakasununguka Phase I test ye 23 varwere vane hupamhi-grade prostatic intraepithelial neoplasia, Zyflamend ndoga kana pamwe pamwe nezvimwe zvokudya zvinowedzera kwemwedzi 18 yakaderedza dambudziko rekusika PCa [156]. Mamwe maRCT muvanhu anodiwa kuti ave nechokwadi chekushanda uye kliniki yekushandiswa kwemushonga uyu.
Zvimwe Zvese Zvekudya Zvibereko & Muriwo
Zvibereko nemiriwo zvakapfuma mavhithamini, mineral uye phytochemicals. Zvidzidzo zvakasiyana-siyana zvepidemiologic zvakawana kupesana kwehutano pakati pemichero yose yemichero uye yemiriro kudya [158], uye cruciferous yemiti yemidziyo yekudya uye PCa ngozi [159,160]. Mishonga yeAllium, yakadai segoriki, maekisi, chives, uye shallots, ine sulfurous phytochemicals yakawanda yakarongedzwa kuti iwedzere maitiro ezvirwere, kudzivirira masero ekukura, kuenzanisa maitiro e androgen-anogadzirisa maitiro uye kuita kuti apoptosis [161] ive. Kunyange zvazvo nhamba yezvinyorwa zvakabudiswa zvisingakwanisi, zvose zvakanyanyisa uye epidemiologic deta zvinoratidza kuti kudya kwemavirumusi inonzi allium inogona kudzivirira kuPCa, kunyanya inowanikwa zvirwere [162]. Muedzo unoshandiswa nemaitiro nevarume ve199 wakawanawo kuti kuwedzera kwepomegranate, green tea, broccoli uye turmeric zvakaderedza zvakanyanya kuwedzera kwePSA mune varume neCCa [163].
Tomato & Tomato Zvigadzirwa
Tsvakurudzo dzinoverengeka dzakaongorora kusangana pakati pekutumirwa kwemasamato uye tomato neCCa asi izvo zvakawanikwa hazvina kukwana. Iyo antioxidant lycopene, iyo yakazara mumatatisi, yakanyatsodzidzawo zvakakonzerwa nemigumisiro yayo pane PCa. In vitro, lycopene inomisa kushandiswa kwemasero muzvikamu zvakasiyana zveCPa uye inoderedza zviratidzo zveGG-1 nekuita kuti IGF-1 isunge mapuroteni [131]. Kunyange zvazvo zvimwe zvidzidzo zvezvipfuwo zvakawana lycopene zvakanonoka kukura PCa kukura [164] kana kuderedza ma PCa epithelial masero pazvikamu zvekudzidzira, kukurudzirwa uye kufambira mberi [165], zvidzidzo zviviri zvakawana kuwirirana kunowanikwa pakati pezvinamato zvinotapira uye [l] 166,167]. Zvidzidzo zvevanhu zvinowanikwa zvakakwirira zvepyclene [168,169] kana yepamusoro serum mazinga zvakabatanidzwa nechepasi PCa ngozi [170], asi vamwe havana [171,172]. Chirwere cheprostatic chycopene pasi pe 1 ng / mg chikumbaridzo chakabatanidzwa neCCa pamwedzi mitanhatu yekutevera-biopsy (P = 0.003) [173]. Mamwe maawa mashomanana ekutanga preprostatectomy achishandisa tomato sauce kana lycopene supplementation akaratidza lycopene kuwanikwa mu prostate tissue uye antioxidant uye inogona kuisa maitiro anticancer [174,175]. Kunyange zvazvo miedzo yakawanda yekliniki yakaratidza kuwirirana kwepakati pe lycopene supplementation, maPSA maitiro uye kuderera kwezviratidzo zvinokonzera kenza (171,176], hapana mimwe mikuru yakakura randomedzesheni yakaedza basa reLycopene kana michero yeParcasi paPaP kudzivirira kana kurapwa.
kofi
Kofi ine caffeine uye yakawanda isingazivikanwe fenolic makemikisi ayo anogona kushanda se antioxidants. Zvidzidzo zveEpidemiological zvinoratidza hukama hwepakati pakati pefivha yekushandisa uye PCa ngozi, kunyanya kwechirwere chepamusoro kana chakauraya, uye zviwanikwa zvaive zvakasununguka nekakineine yezvokudya [177,178]. Kunyange zvazvo zvidzidzo zvakasiyana-siyana zvepademiological [179-182] dzakawana kusabatana pakati pekofi kushandiswa uye PCa ngozi, meta-nyanzvi yezvinoitika yezvidzidzo zvinopedzisa yakagumisa kuti ikhofi inoshandiswa inogona kuderedza PCa ngozi [183]. Izvo zvinogona kuita (s) uye nzira (s) inobatanidzwa hazvizivikanwe asi inogona kusanganisira antioxidant, anti-inflammatory effects, glucose uye insulin metabolism, uye zvinogona kuitika kuIgf-I uye kuparadzanisa mahomoni epabonde.
Dietary Patterns
Kunyange zvazvo zvizhinji zvekudya zvinokwana kana zvikafu zvekudya zvakaongororwa nekuda kwezvavanoita kana kushamwaridzana nePCa ngozi kana kufambira mberi, zvabuda zvacho zvakanyanya kusinganzwisisiki. Chikonzero chinokonzera kusawirirana ndechokuti kukanganisa kwechimwe chinhu chinokonzera kana chikafu chekudya kungave chiduku kudarika kuonekwa. Mukuwedzera, zvibereko zvinowanikwa zviripo muzvokudya kakawanda zvakanyanyobatanidzwa uye zvinogona kuwirirana uye, nokudaro, zvinokanganisa kuitika paPCa. Nokudaro, kuongorora maitiro ekudya kunowedzera kuwedzera Lin et al. BMC Mushonga (2015) 13: 3 Page 8 ye 15 chido asi kutsvakurudza kwave kusingagumi uye mhinduro dziripo dzave dzisingagoneki. Muchikwata chevarume ve293,464, chirongwa chepamusoro chekudya, sezvakaratidzwa neEalthy Eating Index (HEI) chikwata, chakanga chakabatanidzwa nehuwandu hwehuwandu hwePaida pangozi [70]. Zvokudya zveMediterranean, zviri kumusoro mumiriwo, maorivhi, maitiro akaoma, makemikari anorema uye antioxidants, anogara achikurudzirwa kuvarwere kuti vadzivirire Chinetso chepfungwa uye kuneta [184], uye inogona kuratidza chivimbiso muCCa kudzivirira [185]. Hove uye omega-3 fatty acid inoshandiswa mumutauro weMediterranean yakanyanyobatanidzwa nehutachiona hwePCa ngozi. Mukuwedzera, kuratidzira kudya kweMediterranean mushure mekunge kuongororwa kweCaas non-metastatic kwakabatanidzwa nehuwandu hwehutachiwana hwehupenyu [186]. Izvo, iyo yeWestern neyakakwirira yezvokudya zvitsvuku, yakagadzirirwa nyama, hove yakabikwa, chips, mukaka wakawanda wemafuta uye chingwa chakachena, yakabatanidzwa nehuwandu hwekuita PCa [187].
Uyezve, nyika dzeAsia dzine kushandiswa kwakanyanya kweomega-3 PUFAs, soy uye green tea-based phytochemicals, ine zviitiko zvishoma zvePCa zvinopesana nenyika dzinodya "Western-style" kudya [188]. Zvisinei, hazvisi zvidzidzo zvose [189-191] zvakatsigira kushamwaridzana pakati peimwe nzira yekudya uye ngozi yePCa. Zvinokwanisika kuti nzira inoshandiswa pakuziva maitiro ezvokudya inogona kunge isina kutora zvinhu zvose zvekudya zvine chokuita nePCa ngozi. Neimwe nzira, imwe neimwe nzira yekudya inogona kunge iine zvese zvinobatsira uye zvinokuvadza zvikamu zvinokonzeresa kushamwaridzana kusina maturo. Kutsvakurudza kwakawanda kunodiwa kuti urambe uchitsvaga maitiro ezvokudya anobatanidza zvakawanda zvezvikafu zvinobatsira / zvokudya zvekudya zvePCa uye kuderedza zvizhinji zvezvikafu zvakashata / zvekudya.
Future Direction For Clinical Trials
Kubva pane zvakawanda zve epidemiologic, preclinical uye zvipatara zvinotsanangurwa murugwaro urwu, zvirongwa zvekudya zvekudzivirira nekurapa kwePaP zvinobata vimbiso yakawanda. Mukuwedzera, zvinhu zvakawanda zvekudya uye mavitamini / zvigadzirwa zvinogona kuwirirana nePCa ngozi uye / kana kufambira mberi kwezvirwere. Zvinokonzerwa nemiedzo yakarongeka zvinoratidzwa zvakajeka kuti zvigadzire zvibereko zvakasiyana kana kurapwa kwemaitiro ekudzivirira uye kurapa kweCaPa.
Munguva pfupi yapfuura, kushingaira kwekucherechedza (AS) kwakabuda sechisarudzo chinoshanda kune varume vane ngozi shoma PCa. Varume vari paAS vanokurudzirwa kuomerera kune kudya uye mararamiro ekugadzirisa mararamiro [192], zvichiita kuti iyi subset ive chinangwa chakanaka chekupindira kwekudya uye hutano hwemiedzo yehupenyu [193]. PCa vanopona vanonyanya kushingaira uye vanorondedzera "hutano" tsika dzekudya (kureva, kudya kwakaderera-mafuta, yakaderera-yakanatswa carbohydrate kudya yakapfuma mumichero nemiriwo) vane hutano huri nani hwehupenyu hunopesana nevasina kushanda, vasina hutano [194]. Nokudaro, mimwe miedzo yakawandisa inobvumirwa kuti ione iyo yose yenguva refu yemigumisiro yezvokudya zvekupindira muhuwandu hwevanhu. Kunyanya, mibvunzo inokosha yekugadzirisa mumiedzo yeramangwana ndeiyi: 1) Ko kupindira kwezvokudya kunononoka kudiwa kwekurapwa muvarume paAS; 2) Kupindira kwezvokudya kunogona kudzivirira kudzokorora kwevarume mushure mekurapa; 3) Kupindira kwezvokudya kunogona kunonoka kufambira mberi pakati pevarume vane chirwere chinowanzoitika uye, nokudaro, kunonoka kudiwa kwehomoni therapy; 4) Kupindira kwezvokudya kunogona kuderedza migumisiro yemishonga yePCa inosanganisira hormonal therapy uye itsva inotarirwa kurapa; uye 5) Pane here basa rekupindira kwekudya kwega kana kusanganiswa nemishonga inotarirwa muvarume pane hormonal therapy kudzivirira castrate-resistance kana mushure mekubuda kwecastrate resistance disease? Nokuti huchapupu hunowedzera hunoratidza kuti kusagadzikana kwemagetsi kunowedzera ngozi yePCa, mararamiro ehupenyu anovandudza mararamiro emagetsi ndeyekukunda-kukunda sarudzo yePCa kudzivirira uye kurapwa [195,196].
Mhedziso: Cancer yeProstate
Tsvakurudzo yeramangwana inodiwa kuti uone kudya kwakakodzera kwePCa kudzivirira kana kurapwa. Zvisinei, zvinhu zvakasiyana-siyana zvekudya uye mamwe maitiro ezvokudya anobata chivimbiso mukuderedza PCa ngozi kana kufambira mberi uye zvinopindirana nemitemo yezvino yezvokudya zveAmerica [197]. Kune varwere vanopa mazano pamusoro pekudya kwekutanga uye yechipiri PCa kudzivirira, vazhinji vanotenda kuti "moyo une utano hwakaenzana neprostate ine utano." Nokudaro, zvichipiwa migumisiro yemazuva ano isinganzwisisiki, mazano ezvokudya zvakanakisisa zvePCa kudzivirira kana kutungamirira anoita seanosanganisira: kuwedzera michero nemiriwo, kutsiva yakanatswa. makabhohaidhiretsi ane zviyo zvakakwana, kuderedza mafuta akazara uye akazara, kuderedza nyama yakanyanyobikwa uye kudya mwero mwero wemakoriyumu kana kuderedza makabhohaidhiretsi nechinangwa chikuru chekuwana nekuchengetedza huremu hwemuviri hune hutano.
Kunyanya kukwikwidza Vanyori vanotaura kuti havana kukwikwidzana.
Vanyori mipiro P-HL uye SF yakaita ongororo, P-HL yakanyora manyoro uye SF uye WA yakagadziriswa uye yakapa mhinduro yakakosha. Vese vanyori vakaverenga uye vakabvumidza gwaro rekupedzisira.
Kutenda Mariro yakapiwa nemari 1K24CA160653 (Freedland), NIH P50CA92131 (W. Aronson). Ichi chinyorwa ndicho chikonzero chebasa rinotsigirwa nemari uye kushandiswa kwezvivako paVeterans Administration Medical Center, West Los Angeles (W. Aronson).
Munyori wezvinyorwa 1 Dhipatimendi reMishonga, Chikamu cheNefrology, Duke University Medical Center, Bhokisi 3487, Durham, NC 27710, USA. 2 Urology Chikamu, Dhipatimendi Rokuvhiya, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA. 3 Dhipatimendi reUrology, UCLA School of Medicine, Los Angeles, CA, USA. 4 Urology Chikamu, Dhipatimendi Rokuvhiya, Durham Veterans Affairs Medical Center, Chikamu cheUrology, Durham, NC, USA. 5 Duke Prostate Center, Dhipatimendi reKupurika nePathology, Duke University Medical Center, Durham, NC, USA.
pasina
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