Miyoshi Yasuhide, Uemura Hiroji, Umemoto Susumu, Sakamaki Kentaro, Morita Satoshi, Suzuki Kazuhiro, Shibata Yasuhiro, Masumori Naoya, Ichikawa Tomohiko, Mizokami Atsushi, Sugimura Yoshiki, Nonomura Norio, Sakai Hideki, Honma Seijiro, Harada Masaoki, Kubota Yoshinobu
Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
BMC Cancer. 2014 Sep 26;14:717. doi: 10.1186/1471-2407-14-717.
There is currently no consensus on the correlations between androgen concentrations in prostate tissue and blood and stage and pathological grade of prostate cancer. In this study, we used a newly-developed ultra-sensitive liquid-chromatography tandem mass spectrometry method to measure testosterone (T) and dihydrotestosterone (DHT) concentrations in blood and needle biopsy prostate specimens from patients with prostate cancer.
We analyzed androgen levels in 196 men diagnosed with prostate cancer. All patients had undergone systematic needle biopsy, and an additional needle biopsy from the peripheral zone was conducted for the simultaneous determination of T and DHT. We analyzed the relationships between T and DHT levels in tissue and blood and Gleason score, clinical stage, and percentage of positive biopsy cores, using multivariate analysis.
The median T and DHT levels in blood were 3551.0 pg/mL and 330.5 pg/mL, respectively. There was a strong correlation between serum T and DHT. The median T and DHT levels in prostate tissue were 0.5667 pg/mg and 7.0625 pg/mg, respectively. In multivariate analysis, serum prostate-specific antigen and tissue T levels were significantly associated with poor prognosis; high T levels in prostate tissue were significantly related to high Gleason score (p = 0.041), advanced clinical stage (p = 0.002), and a high percentage of positive biopsy cores (p = 0.001).
The results of this study indicate that high T levels in prostate tissue are related to high Gleason score, advanced clinical stage, and a high percentage of positive biopsy cores in patients with prostate cancer. T level in needle biopsy specimens may therefore be a useful prognostic factor in prostate cancer patients.
目前，前列腺组织和血液中的雄激素浓度与前列腺癌的分期及病理分级之间的相关性尚无定论。在本研究中，我们使用一种新开发的超灵敏液相色谱串联质谱法，来测定前列腺癌患者血液及穿刺活检前列腺标本中的睾酮（T）和双氢睾酮（DHT）浓度。
我们分析了196例被诊断为前列腺癌的男性患者的雄激素水平。所有患者均接受了系统的穿刺活检，并从外周区额外进行了一次穿刺活检，以同时测定T和DHT。我们使用多变量分析方法，分析了组织和血液中的T和DHT水平与 Gleason评分、临床分期及活检阳性核心百分比之间的关系。
血液中T和DHT的中位数水平分别为3551.0 pg/mL和330.5 pg/mL。血清T和DHT之间存在强相关性。前列腺组织中T和DHT的中位数水平分别为0.5667 pg/mg和7.0625 pg/mg。在多变量分析中，血清前列腺特异性抗原和组织T水平与预后不良显著相关；前列腺组织中高T水平与高Gleason评分（p = 0.041）、晚期临床分期（p = 0.002）及高活检阳性核心百分比（p = 0.001）显著相关。
本研究结果表明，前列腺组织中高T水平与前列腺癌患者的高Gleason评分、晚期临床分期及高活检阳性核心百分比相关。因此，穿刺活检标本中的T水平可能是前列腺癌患者一个有用的预后因素。
