Is low serum free testosterone a marker for high grade prostate cancer?
Is low serum free testosterone a marker for high grade prostate cancer?
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DOI：
10.1016/s0022-5347(05)67812-3
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发表时间：
2000-03-01
影响因子：
6.6
通讯作者：
Morgentaler, A
中科院分区：
文献类型：
--
作者：
Hoffman, MA;DeWolf, WC;Morgentaler, A
目的：游离睾酮和总睾酮与前列腺癌的关系尚不完全清楚。我们研究了血清游离睾酮和总睾酮与前列腺癌临床和病理特征的关系。材料和方法：我们回顾性回顾了 1994 年至 1997 年间在我们的医疗中心由 1 名医生治疗并诊断为前列腺癌的 117 名连续患者的临床记录。低游离睾酮和总睾酮水平分别定义为 1.5 或更低和 300 ng/dl。 结果：在评估所有 117 名患者后，我们注意到游离睾酮和总睾酮与前列腺特异性抗原、患者年龄、前列腺体积、活检阳性百分比、活检格里森评分或临床分期没有相关性。然而，与游离睾酮水平正常的患者相比，游离睾酮水平较低的患者中，活检显示癌症的平均百分比有所增加（43% vs 22%，p = 0.013），活检格里森评分为 8 或更高的发生率也有所增加（64 例中的 7 例 vs 48 例中的 0 例，p = 0.025）。在 117 名患者中，有 57 名接受了根治性耻骨后前列腺切除术。在游离睾酮水平较低的患者中，与正常游离睾酮水平的患者相比，活检显示癌症的平均百分比有所增加（47% vs 28%，p = 0.018），病理学评估显示，游离睾酮水平较低的患者中，分别有 31%、64%、8% 和 0% 处于 pT2ab、pT2c、pT3 和 pT4 期疾病，而游离睾酮水平较低的患者中，这一比例分别为 40%、40.6%、12.5% 和 6.2%。游离睾酮正常（p > 0.05），结论：在我们的研究中，游离睾酮水平较低的前列腺癌患者患有更广泛的疾病。此外，所有活检格里森评分为 8 或更高的男性血清游离睾酮水平较低。这一发现表明，低血清游离睾酮可能是更具侵袭性疾病的标志。
Purpose: The association of free and total testosterone with prostate cancer is incompletely understood. We investigated the relationship of serum free and total testosterone to the clinical and pathological characteristics of prostate cancer.Materials and Methods: We retrospectively reviewed the clinical records of 117 consecutive patients treated by 1 physician and diagnosed with prostate cancer at our medical center between 1994 and 1997. Low free and total testosterone levels were defined as 1.5 or less and 300 ng,/dl., respectively.Results: After evaluating all 117 patients we noted no correlation of free and total testosterone with prostate specific antigen, patient age, prostatic volume, percent of positive biopsies, biopsy Gleason score or clinical stage. However, in patients with low versus normal free testosterone there were an increased mean percent of biopsies that showed cancer (43% versus 22%, p = 0.013) and an increased incidence of a biopsy Gleason score of 8 or greater (7 of 64 versus 0 of 48, p = 0.025), Of the 117 patients 57 underwent radical retropubic prostatectomy. In those with low versus normal free testosterone an increased mean percent of biopsies demonstrated cancer (47% versus 28%, p = 0.018), Pathological evaluation revealed stage pT2ab, pT2c, pT3 and pT4 disease, respectively, in 31%, 64%, 8% and 0% of patients with low and in 40%, 40.6%, 12.5% and 6.2% in those with normal free testosterone (p > 0.05),Conclusions: In our study patients with prostate cancer and low free testosterone had more extensive disease. In addition, all men with a biopsy Gleason score of 8 or greater had low serum free testosterone. This finding suggests that low serum free testosterone may be a marker for more aggressive disease.