Yassin Aksam, Salman Mahmoud, Talib Riadh A, Yassin Dany-Jan
a Institute of Urology & Andrology , Norderstedt-Hamburg , Germany.
b Gulf Medical University , Ajman , UAE.
Aging Male. 2017 Jun;20(2):125-133. doi: 10.1080/13685538.2017.1298584. Epub 2017 Mar 10.
This study investigated the role of testosterone replacement therapy (TRT) in prostate safety and cancer progression. A cohort of 553 patients, 42 treated and 162 untreated hypogonadal men, and 349 eugonadal men were included. Pathological analysis of prostate biopsies examining the incidence and severity of PCa revealed that: 16.7% of treated hypogonadal men had a positive biopsy, a Gleason score of ≤6 in 71.4% and >6 in 28.6% of men, a predominant score of 3 and tumour staging of II in 85.7% men; 51.9% of untreated hypogonadal men had a positive biopsy, a Gleason score of ≤6 in 40.5% and >6 in 59.5% men, a predominant score of 3 (77.4%) and tumour staging of II (41.7%) or III (40.5%); 37.8% of eugonadal men had a positive biopsy, a Gleason score of ≤6 in 42.4% and >6 in 57.6% of men, a predominant score of 3 (82.6%) and tumour staging of II (44.7%) or III (47.7%). The incidence of positive prostate biopsies was lowest in hypogonadal men receiving TRT, with significantly lower severity of PCa in terms of staging and grading in the same group. These results suggest that TRT might have a protective effect against high-grade PCa.
本研究调查了睾酮替代疗法（TRT）在前列腺安全性和癌症进展中的作用。纳入了一组553例患者，其中42例接受治疗的性腺功能减退男性、162例未接受治疗的性腺功能减退男性和349例性腺功能正常的男性。对前列腺活检进行病理分析以检查前列腺癌（PCa）的发病率和严重程度，结果显示：16.7%接受治疗的性腺功能减退男性活检呈阳性，71.4%的男性Gleason评分≤6，28.6%的男性Gleason评分>6，85.7%的男性主要评分为3且肿瘤分期为II期；51.9%未接受治疗的性腺功能减退男性活检呈阳性，40.5%的男性Gleason评分≤6，59.5%的男性Gleason评分>6，77.4%的男性主要评分为3，41.7%或40.5%的男性肿瘤分期为II期或III期；37.8%性腺功能正常的男性活检呈阳性，42.4%的男性Gleason评分≤6，57.6%的男性Gleason评分>6，82.6%的男性主要评分为3，44.7%或47.7%的男性肿瘤分期为II期或III期。接受TRT的性腺功能减退男性前列腺活检阳性的发生率最低，且同一组中PCa在分期和分级方面的严重程度显著较低。这些结果表明，TRT可能对高级别PCa具有保护作用。
