Dihydrotestosterone and testosterone levels in men screened for prostate cancer: A study of a randomized population
Dihydrotestosterone and testosterone levels in men screened for prostate cancer: A study of a randomized population
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DOI：
10.1046/j.1464-410x.1996.89120.x
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发表时间：
1996-03-01
期刊：
影响因子：
--
通讯作者：
Nyman, CR
中科院分区：
文献类型：
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作者：
Gustafsson, O;Norming, U;Nyman, CR
目的探讨前列腺癌患者血清前列腺特异性抗原（PSA）、双氢睾酮（DHT）、睾酮、性激素结合球蛋白（SHBG）水平与肿瘤分期、分级及倍体的关系。研究对象和方法从26602名年龄在55 - 70岁之间的男性中随机选择2400名，并邀请他们进行前列腺癌的筛查，使用直肠指检、经直肠超声检查和PSA分析。在1782名与会者中，诊断出65例前列腺癌。每个病例与筛选人群中年龄和前列腺体积相似的两名对照受试者相匹配。分析冷冻血清样本的PSA、DHT、睾酮和SHBG，并与诊断和肿瘤分期、分级和倍性进行比较。结果除肿瘤倍体外，前列腺癌患者的PSA水平与其他变量之间均存在显著性差异，前列腺癌患者的DHT水平略低，但差异无统计学意义。在更晚期的肿瘤中，有一种降低DHT值的趋势，T分期的差异接近统计学显著性（P=0.059）。癌症患者的睾酮水平低于对照组，但差异不显著。睾酮水平，肿瘤分期和倍性之间没有相关性，但低分化肿瘤睾酮水平的差异相比，与中间和高级别的几乎是显着的（P=0.058）。睾丸激素/双氢睾酮比率在更晚期肿瘤患者中倾向于更高，SHBG水平在癌症患者中低于对照组，但差异无统计学意义。多因素分析表明，在已知PSA水平的情况下，DHT、睾酮或SHBG均不能提供进一步的诊断、分期、分级或倍性信息。对T分期、PSA水平和DHT的回归分析表明，T-3期PSA与DHT呈负线性关系结论PSA对区分肿瘤患者与正常人、肿瘤分期和分级有一定的价值，但与倍体无明显相关性。如果PSA水平是已知的，则在个体病例中没有其他变量增加信息。在一组中，在病例中和那些具有更晚期肿瘤的病例中，DHT水平倾向于较低。肿瘤体积（如由PSA水平定义的）和5 α-还原酶活性（如由DHT水平定义的）与睾酮/DHT比率之间存在反比关系。这种趋势在T分期最为明显，睾酮或SHBG水平未发现系统性变化。
Objective To investigate the possible relationship between serum levels of prostate specific antigen (PSA), dihydrotestosterone (DHT), testosterone, sexual-hormone binding globulin (SHBG) and tumour stage, grade and ploidy in 65 cases of prostate cancer diagnosed in a screening study compared to 130 controls from the same population.Patients, subjects and methods From a population of 26 602 men between the ages of 55 and 70 years, 2400 were selected randomly and invited to undergo screening for prostate cancer using a digital rectal examination, transrectal ultrasonography and PSA analysis. Among the 1782 attendees, 65 cases of prostate cancer were diagnosed. Each case was matched with two control subjects of similar age and prostate volume from the screening population. Frozen serum samples were analysed for PSA, DHT, testosterone and SHBG, and compared to the diagnosis and tumour stage, grade and ploidy. Comparisons between these variables, and multivariate and regression analyses were performed.Results There were significant differences in PSA level with all variables except tumour ploidy, DHT levels were slightly lower in patients with prostate cancer but the difference was not statistically significant. There was a trend towards lower DHT values in more advanced tumours and the difference for T-stages was close to statistical significance (P=0.059). Testosterone levels were lower in patients with cancer than in the control group, but the differences were not significant. There was no correlation between testosterone levels, tumour stage and ploidy, but the differences in testosterone level in tumours of a low grade of differentiation compared to those with intermediate and high grade was nearly significant (P=0.058). The testosterone/DHT ratio tended to be higher in patients with more advanced tumours, SHBG levels were lower in patients with cancer than in controls but the differences were not statistically significant. There were no systematic variations of tumour stage, grade and ploidy, Multivariate analysis showed that if the PSA level was known, then DHT, testosterone or SHBG added no further information concerning diagnosis, stage, grade or ploidy, Regression analysis on T-stage, PSA level and DHT showed an inverse linear relationship between PSA and DHT for stage T-3 (P=0.035), but there was no relationship between PSA and testosterone.Conclusion PSA was of value in discriminating between cases and controls and between various tumour stages and grades, but no statistically significant correlation was found for ploidy. If PSA level was known, no other variable added information in individual cases, Within a group, DHT levels tended to be lower among cases and in those with more advanced tumours, There was an inverse relationship between tumour volume, as defined by PSA level, and 5 alpha-reductase activity, as defined by DHT level, and the testosterone/DHT ratio. This trend was most obvious with T-stage, No systematic variation were found in the levels of testosterone or SHBG.