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5α还原酶抑制剂通过抑制5α还原酶降低双氢睾酮水平。应用5α还原酶抑制剂进行的前列腺癌预防研究显示,5α还原酶抑制剂可以降低前列腺癌发病率,但同时也出现高级别前列腺癌病例增加的现象,引起广泛关注。有研究和分析显示,5α还原酶抑制剂使前列腺体积缩小,同时也缩小Gleason评分为3分患者的前列腺癌体积,使得再次穿刺更容易发现Gleason评分为4分以上的前列腺癌。另外5α还原酶抑制剂显著提高前列腺穿刺诊断前列腺癌和高级别前列腺癌敏感度。笔者认为5α还原酶抑制剂不但不增加高级别前列腺癌的发生率,反而会帮助我们更早发现高级别前列腺癌。
5α reductase inhibitors reduce dihydrotestosterone levels by inhibiting 5α-reductase. Prostate cancer prevention studies using 5α-reductase inhibitors have shown that 5α-reductase inhibitors can reduce the incidence of prostate cancer, but also an increase in cases of high-grade prostate cancer, causing widespread concern. Studies and analyzes have shown that 5α-reductase inhibitors reduce the prostate volume and also reduce the prostate cancer volume in patients with a Gleason score of 3, which makes it easier to find another prostate cancer with a Gleason score of 4 or more by re-puncture. In addition, 5α-reductase inhibitors significantly improve prostate biopsy in the diagnosis of prostate cancer and high-grade prostate cancer. I believe that 5α-reductase inhibitors not only do not increase the incidence of high-grade prostate cancer, but will help us find an earlier high-grade prostate cancer.