前列腺特异性抗原基因ARE-I区域的多态性与低血清睾酮水平和高级别前列腺癌相关。

Polymorphism in ARE-I region of prostate-specific antigen gene associated with low serum testosterone level and high-grade prostate cancer.

作者信息

Schatzl Georg, Marberger Michael, Remzi Mesut, Grösser Petra, Unterlechner Julia, Haidinger Gerald, Zidek Thomas, Preyer Martin, Micksche Michael, Gsur Andrea

机构信息

Department of Urology, Medical University of Vienna, Vienna, Austria.

出版信息

Urology. 2005 Jun;65(6):1141-5. doi: 10.1016/j.urology.2004.12.019.

DOI:10.1016/j.urology.2004.12.019

PMID:15893813

Abstract

OBJECTIVES

To examine the impact of polymorphism in the androgen-responsive element I region of the prostate-specific antigen (PSA) gene on the serum testosterone level and Gleason score in patients with newly diagnosed, untreated prostate cancer (PCa). High-grade PCa is associated with a low serum testosterone level, and the testosterone level has been negatively correlated with the expression of PSA.

METHODS

Endocrine factors (including testosterone, follicle-stimulating hormone, and luteotropic hormone), PSA level, prostate volume, and Gleason score were measured in 134 patients with untreated, biopsy-verified PCa. PSA polymorphism was determined by polymerase chain reaction-based methods using DNA from peripheral blood samples.

RESULTS

Patients with the PSA G/G genotype had lower serum testosterone levels (3.5 +/- 1.2 ng/mL) than those with the A/A genotype (4.3 +/- 1.6 ng/mL) or the A/G genotype (4.4 +/- 1.5 ng/mL). The PSA level in the A/A and A/G genotype groups were significantly lower than that in the G/G genotype group (18.2 +/- 55.0 ng/mL versus 20.5 +/- 27.6 ng/mL, P = 0.013). In a multiple logistic regression model, the odds ratio for the G/G polymorphism was significantly increased for Gleason score (odds ratio 2.4, 95% confidence interval 1.6 to 10.4; P = 0.02) and serum testosterone level (odds ratio 0.44, 95% confidence interval 0.36 to 0.94; P = 0.01) relative to genotypes A/A and A/G.

CONCLUSIONS

Our results showed that the PSA G/G genotype is associated with a greater Gleason score and serum PSA level but lower serum testosterone level and could be considered a risk factor for a poor outcome of PCa.

摘要

目的

研究前列腺特异性抗原（PSA）基因雄激素反应元件I区域的多态性对新诊断的未经治疗的前列腺癌（PCa）患者血清睾酮水平和 Gleason 评分的影响。高级别 PCa 与低血清睾酮水平相关，且睾酮水平与 PSA 的表达呈负相关。

方法

对 134 例未经治疗的、经活检证实的 PCa 患者测量内分泌因子（包括睾酮、促卵泡激素和促黄体激素）、PSA 水平、前列腺体积和 Gleason 评分。使用外周血样本的 DNA 通过基于聚合酶链反应的方法确定 PSA 多态性。

结果

PSA G/G 基因型患者的血清睾酮水平（3.5±1.2 ng/mL）低于 A/A 基因型患者（4.3±1.6 ng/mL）或 A/G 基因型患者（4.4±1.5 ng/mL）。A/A 和 A/G 基因型组的 PSA 水平显著低于 G/G 基因型组（18.2±55.0 ng/mL 对 20.5±27.6 ng/mL，P = 0.013）。在多因素逻辑回归模型中，相对于 A/A 和 A/G 基因型，G/G 多态性的优势比在 Gleason 评分方面显著增加（优势比 2.4，95%置信区间 1.6 至 10.4；P = 0.02），在血清睾酮水平方面也显著增加（优势比 0.44，95%置信区间 0.36 至 0.94；P = 0.01）。