Guéchot J, Peigney N, Ballet F, Vaubourdolle M, Giboudeau J, Poupon R
Service de Biochimie-Hormonologie, Hôpital Saint Antoine, Paris, France.
Cancer. 1988 Aug 15;62(4):760-2. doi: 10.1002/1097-0142(19880815)62:4<760::aid-cncr2820620420>3.0.co;2-6.
To investigate the possible role of sex-hormone imbalance in hepatocellular carcinogenesis in male alcoholic cirrhotic patients, we determined plasma levels of testosterone (T), dihydrotestosterone (DHT), androstenedione (A), dehydroepiandrosterone (DHA), estrone (E1), estradiol (E2), and sex-hormone-binding globulin (SHBG) in 15 men with alcoholic cirrhosis alone and in 15 similar men with alcoholic cirrhosis and hepatocellular carcinoma (HCC). The groups were matched for age and severity of liver disease using Child-Pugh scoring. Patients of both groups had evidence of hypogonadism with a decrease in plasma T levels (P less than 0.02) and of hyperestrogenemia with an increase in E1 (P less than 0.001), E2 (P less than 0.01), and SHBG (P less than 0.01) plasma levels compared with ten healthy age-matched controls. Cirrhotic patients with HCC had significantly lower plasma concentrations of T (P less than 0.02), DHT (P less than 0.01), and DHA (P less than 0.001) than patients with cirrhosis alone. However, the plasma concentrations of A, E1, E2, and SHBG did not significantly differ between these two groups. These results suggest a possible alteration of the estrogen-to-androgen ratio during carcinogenesis of the cirrhotic liver. This is shown by a greater reduction of circulating androgens and a similar elevation of estrogens in the group of cirrhotics with HCC.
为了研究性激素失衡在男性酒精性肝硬化患者肝细胞癌发生过程中可能发挥的作用，我们测定了15名单纯酒精性肝硬化男性患者以及15名患有酒精性肝硬化并伴有肝细胞癌（HCC）的类似男性患者血浆中的睾酮（T）、双氢睾酮（DHT）、雄烯二酮（A）、脱氢表雄酮（DHA）、雌酮（E1）、雌二醇（E2）和性激素结合球蛋白（SHBG）水平。使用Child-Pugh评分将两组患者的年龄和肝病严重程度进行匹配。与10名年龄匹配的健康对照相比，两组患者均有性腺功能减退的证据，表现为血浆T水平降低（P<0.02），以及雌激素血症，表现为E1（P<0.001）、E2（P<0.01）和SHBG（P<0.01）血浆水平升高。与单纯肝硬化患者相比，患有HCC的肝硬化患者血浆中T（P<0.02）、DHT（P<0.01）和DHA（P<0.001）的浓度显著降低。然而，这两组患者血浆中A、E1、E2和SHBG的浓度没有显著差异。这些结果表明，在肝硬化肝脏癌变过程中雌激素与雄激素的比例可能发生改变。这表现为在患有HCC的肝硬化患者组中，循环雄激素的降低幅度更大，而雌激素的升高幅度相似。
