在接受前列腺活检的男性中，较高的游离睾酮百分比与高级别前列腺癌相关。
Greater percent-free testosterone is associated with high-grade prostate cancer in men undergoing prostate biopsy.
机构信息
Department of Urology, Sant'Andrea Hospital, Second School of Medicine, La Sapienza University, Rome, Italy.
出版信息
Urology. 2012 Jul;80(1):162-7. doi: 10.1016/j.urology.2012.01.068. Epub 2012 May 18.
OBJECTIVE
To analyze the serum androgen concentrations in men who underwent an initial prostate biopsy, focusing on the percent-free testosterone (%FT) as a predictor of low- and high-grade prostate cancer (PCa). Most studies have suggested that the absolute serum testosterone and free testosterone levels are not related to PCa risk. However, to date, the concurrent effect of free and total testosterone levels has not been evaluated. In particular, the association of the %FT (free testosterone/total testosterone) with PCa risk has not been explored.
METHODS
From 2006 to 2010, we collected data on 812 white Italian men with no history of PCa who underwent 12-core biopsy. The testosterone, free testosterone, and %FT (free testosterone/total testosterone) were examined as predictors of low-grade (Gleason score of ≤ 6) and high-grade (Gleason score ≥ 7) PCa using crude and adjusted multinomial logistic regression analysis.
RESULTS
On multivariate analysis, testosterone (P ≥ .11) and free testosterone (P ≥ .45) were not significantly associated with low- or high-grade PCa. A greater %FT level significantly predicted high-grade PCa on both crude (P = .01) and multivariate (P = .02) analysis but not low-grade PCa (P ≥ .38). When examined in tertiles, men in the greatest %FT tertile had a significant twofold increased risk of high-grade PCa (odds ratio 2.04, 95% confidence interval 1.23-3.37, P = .005).
CONCLUSION
In white Italian men, a greater %FT level was associated with an increased risk of high-grade PCa on initial prostate biopsy. These findings suggest that a high %FT level, rather than the absolute androgen levels, might be associated with high-grade PCa. Additional studies are needed to confirm our findings.
目的
分析首次接受前列腺活检的男性的血清雄激素浓度，重点关注游离睾酮百分比（%FT）作为低级别和高级别前列腺癌（PCa）的预测指标。大多数研究表明，血清总睾酮和游离睾酮水平与 PCa 风险无关。然而，迄今为止，游离和总睾酮水平的并发效应尚未得到评估。特别是，游离睾酮百分比（%FT，游离睾酮/总睾酮）与 PCa 风险的相关性尚未得到探讨。
方法
我们于 2006 年至 2010 年期间，收集了 812 名无前列腺癌病史的意大利白人男性的数据，他们接受了 12 核活检。使用粗和调整后的多项逻辑回归分析，将睾酮、游离睾酮和%FT（游离睾酮/总睾酮）作为低级别（Gleason 评分≤6）和高级别（Gleason 评分≥7）PCa 的预测因子进行了检查。
结果
在多变量分析中，睾酮（P≥.11）和游离睾酮（P≥.45）与低级别或高级别 PCa 均无显著相关性。更大的%FT 水平在粗（P=.01）和多变量（P=.02）分析中均显著预测高级别 PCa，但不预测低级别 PCa（P≥.38）。在三分位分析中，处于最大%FT 三分位的男性患高级别 PCa 的风险显著增加两倍（优势比 2.04，95%置信区间 1.23-3.37，P=.005）。
结论
在意大利白人男性中，更大的%FT 水平与初始前列腺活检时高级别 PCa 的风险增加相关。这些发现表明，较高的%FT 水平，而不是绝对雄激素水平，可能与高级别 PCa 相关。需要进一步的研究来证实我们的发现。
Zotero 插件