Nishiyama Tsutomu, Ikarashi Toshihiko, Hashimoto Yutaka, Suzuki Kazuya, Takahashi Kota
Division of Urology, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
J Urol. 2006 Oct;176(4 Pt 1):1387-91. doi: 10.1016/j.juro.2006.06.066.
To our knowledge the association between dihydrotestosterone in the prostate and prostate cancer aggressiveness has not yet been elucidated. We analyzed dihydrotestosterone levels in the prostate and Gleason score in patients diagnosed with clinically localized prostate cancer.
A total of 81 patients with suspected prostate cancer underwent prostate biopsy. Serum samples were collected before biopsy. Dihydrotestosterone levels in prostatic tissue and serum were analyzed using liquid chromatography/electrospray ionization-mass spectrometry after polar derivatization.
A total of 47 patients were diagnosed with stages T1 to T3N0M0 prostate cancer and 34 were diagnosed with no malignancy. Of the 47 patients 32 had a Gleason score of 6 or less and 15 had a score of 7 to 10. Dihydrotestosterone in prostatic tissue in patients with Gleason score 7 to 10 disease was significantly lower than in those with Gleason score 6 or less disease (p = 0.025). Gleason score correlated with the testosterone-to-serum dihydrotestosterone ratio (rs = 0.329, p = 0.038).
Patients with Gleason score 7 to 10 prostate cancer have low dihydrotestosterone in the prostate, although there were no significant differences between patients with Gleason score 7 to 10 vs 6 or less prostate cancer with respect to serum androgens. Low dihydrotestosterone in cases of aggressive prostate cancer is probably sufficient to activate androgen receptor expression and propagate tumor growth.
据我们所知，前列腺中的双氢睾酮与前列腺癌侵袭性之间的关联尚未阐明。我们分析了临床局限性前列腺癌患者前列腺中的双氢睾酮水平和 Gleason 评分。
共有 81 例疑似前列腺癌患者接受了前列腺活检。在活检前采集血清样本。经极性衍生化后，采用液相色谱/电喷雾电离质谱法分析前列腺组织和血清中的双氢睾酮水平。
共有 47 例患者被诊断为 T1 至 T3N0M0 期前列腺癌，34 例被诊断为无恶性肿瘤。在这 47 例患者中，32 例 Gleason 评分为 6 分或更低，15 例评分为 7 至 10 分。Gleason 评分为 7 至 10 分疾病患者的前列腺组织中的双氢睾酮水平显著低于 Gleason 评分为 6 分或更低疾病的患者（p = 0.025）。Gleason 评分与睾酮与血清双氢睾酮比值相关（rs = 0.329，p = 0.038）。
Gleason 评分为 7 至 10 分的前列腺癌患者前列腺中的双氢睾酮水平较低，尽管 Gleason 评分为 7 至 10 分的患者与 Gleason 评分为 6 分或更低的前列腺癌患者在血清雄激素方面无显著差异。侵袭性前列腺癌病例中低双氢睾酮水平可能足以激活雄激素受体表达并促进肿瘤生长。
