Marks Leonard S, Mostaghel Elahe A, Nelson Peter S
Department of Urology, University of California, Los Angeles, Geffen School of Medicine, Los Angeles, California, USA.
Urology. 2008 Aug;72(2):247-54. doi: 10.1016/j.urology.2008.03.033. Epub 2008 May 27.
Direct determination of androgen levels in prostate tissue provides a perspective on the organ that is not available via androgen serum levels. The principle prostatic androgens, primarily dihydrotestosterone (DHT) and secondarily testosterone, can be readily assayed in quick-frozen prostate biopsy cores or surgical specimens. Such assays have proved important in establishing (1) that DHT is a permissive factor in BPH pathogenesis, (2) a mechanism for the treatment of BPH, (3) an understanding of prostate cancer chemoprevention, (4) an explanation for the 'escape' of prostate cancer from castration therapy, (5) prostate safety of testosterone replacement therapy, and (6) insights into the cause of racial differences of prostate cancer. Future opportunities include clarification of new drug mechanisms for BPH and prostate cancer, as well as a better understanding of the pathogenesis of both, and as an aid in individual patient management. Determination of prostate tissue androgens may soon transition from research tool to clinical test.
直接测定前列腺组织中的雄激素水平，能提供一种通过雄激素血清水平无法获得的对该器官的观察视角。主要的前列腺雄激素，主要是二氢睾酮（DHT），其次是睾酮，可以在快速冷冻的前列腺活检组织芯或手术标本中轻松检测。这些检测已被证明在以下方面很重要：（1）确定DHT是良性前列腺增生（BPH）发病机制中的一个允许因子；（2）建立BPH的治疗机制；（3）理解前列腺癌化学预防；（4）解释前列腺癌对去势治疗的“逃逸”现象；（5）睾酮替代疗法的前列腺安全性；（6）深入了解前列腺癌种族差异的原因。未来的机会包括阐明治疗BPH和前列腺癌的新药机制，以及更好地理解两者的发病机制，并辅助个体患者管理。前列腺组织雄激素的测定可能很快会从研究工具转变为临床检测。
