Morote Juan, Ramirez Cristobal, Gómez Esther, Planas Jacques, Raventós Carles X, de Torres Inés M, Catalán Roberto
Translational Prostate Cancer Research Program, Vall d'Hebron Hospital, Autónoma University, Medical School, Barcelona, Spain.
BJU Int. 2009 Aug;104(4):486-9. doi: 10.1111/j.1464-410X.2009.08378.x. Epub 2009 Feb 10.
To analyse the relationship between the levels of total and free serum testosterone and the risk of prostate cancer and tumour aggressiveness.
Total and free serum testosterone were determined in 478 patients consecutively assessed by transrectal ultrasonography-guided prostate biopsy because of an abnormal digital rectal examination and/or serum prostate-specific antigen (PSA) level of >4.0 ng/mL. Tumour aggressiveness was assessed according to serum PSA level, biopsy Gleason score and clinical stage in the subset of 216 patients with cancer (45.2%). We also compared prostate cancer risk and tumour aggressiveness in 80 hypogonadal patients (16.7%) and 398 eugonadal patients (83.3%).
The median total serum testosterone level in patients without and with prostate cancer was 466.0 and 466.5 ng/dL, respectively (P > 0.05); the median levels of free serum testosterone were 9.9 and 10.0 pg/mL, respectively (P > 0.05). The cancer detection rate in hypogonadal patients was 41.3% (33/80) and 46.0% in eugonadal patients (183/398) (P > 0.05). The median level of total testosterone was 433 ng/dL in patients with low-risk prostate cancer, 467 ng/dL in those with intermediate-risk tumours and 468 ng/dL in those with high-risk tumours (P > 0.05); the median levels of free testosterone were 9.4, 9.8 and 10.3 pg/mL, respectively (P > 0.05).
Prostate cancer risk and tumour aggressiveness are not related to serum levels of total and free testosterone, but hypogonadal patients do not have a greater risk of prostate cancer and tumour aggressiveness.
分析血清总睾酮和游离睾酮水平与前列腺癌风险及肿瘤侵袭性之间的关系。
对478例因直肠指检异常和/或血清前列腺特异性抗原（PSA）水平>4.0 ng/mL而接受经直肠超声引导下前列腺穿刺活检的患者，测定其血清总睾酮和游离睾酮水平。在216例癌症患者（45.2%）亚组中，根据血清PSA水平、穿刺活检Gleason评分和临床分期评估肿瘤侵袭性。我们还比较了80例性腺功能减退患者（16.7%）和398例性腺功能正常患者（83.3%）的前列腺癌风险和肿瘤侵袭性。
无前列腺癌患者和有前列腺癌患者的血清总睾酮水平中位数分别为466.0和466.5 ng/dL（P>0.05）；游离睾酮水平中位数分别为9.9和10.0 pg/mL（P>0.05）。性腺功能减退患者的癌症检出率为41.3%（33/80），性腺功能正常患者为46.0%（183/398）（P>0.05）。低风险前列腺癌患者的总睾酮水平中位数为433 ng/dL，中风险肿瘤患者为467 ng/dL，高风险肿瘤患者为468 ng/dL（P>0.05）；游离睾酮水平中位数分别为9.4、9.8和10.3 pg/mL（P>0.05）。
前列腺癌风险和肿瘤侵袭性与血清总睾酮和游离睾酮水平无关，但性腺功能减退患者患前列腺癌和肿瘤侵袭性的风险并不更高。
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