Pejčić Tomislav, Tosti Tomislav, Tešić Živoslav, Milković Borivoj, Dragičević Dejan, Kozomara Milutin, Čekerevac Milica, Džamić Zoran
Clinic of Urology, Clinical Center of Serbia, Belgrade, Serbia.
Faculty of Chemistry, University of Belgrade, Belgrade, Serbia.
Prostate. 2017 Jul;77(10):1082-1092. doi: 10.1002/pros.23365. Epub 2017 Jun 8.
There is still no consensus regarding intraprostatic androgen levels and the accumulation of androgens in the hyperplastic prostatic tissue. The current opinion is that intraprostatic dihydrotestosterone (DHT) concentrations are maintained but not elevated in benign prostatic hyperplasia (BPH), while there is no similar data concerning intraprostatic testosterone (T).
Tissue T (tT) and tissue DHT (tDHT) concentration were determined in 93 patients scheduled for initial prostate biopsy. The criteria for biopsy were abnormal DRE and/or PSA > 4 ng/mL. Total prostate volume (TPV) was determined by transrectal ultrasound (TRUS). During TRUS- guided prostate biopsy, 10-12 samples were collected from the peripheral zone (PZ) and two additional samples were collected from the transition zone (TZ). The samples from the TZ were immediately frozen in liquid nitrogen at -70°C, and transported for tissue androgen determination, using liquid chromatography mass spectrometry (LC-MS).
Pathological analysis revealed that prostate cancer (PCa) was present in 45 and absent in 48 patients. In the whole group, there were 42 men with small prostate (TPV < 30 mL) and 51 with enlarged prostate (TPV ≥ 31 mL). The overall average tT level was 0.79 ± 0.66 ng/g, while the average tDHT level was 10.27 ± 7.15 ng/g. There were no differences in tT and tDHT level in prostates with and without PCa. However, tT and tDHT levels were significantly higher in larger, than in smaller prostates (tT: 1.05 ± 0.75 and 0.46 ± 0.29 ng/g, and tDHT: 15.0 ± 6.09 and 4.51 ± 2.75 ng/g, respectively). There were strong correlations between tT and TPV (r = 0.71), and tDHT and TPV (r = 0.74).
The present study confirmed that both T and DHT accumulated in the stroma of enlarged prostates; the degree of accumulation correlated with prostate volume.
关于前列腺内雄激素水平以及雄激素在增生性前列腺组织中的蓄积，目前仍未达成共识。目前的观点是，在良性前列腺增生（BPH）中，前列腺内双氢睾酮（DHT）浓度保持不变但并未升高，而关于前列腺内睾酮（T）则没有类似数据。
对93例计划进行初次前列腺活检的患者测定组织T（tT）和组织DHT（tDHT）浓度。活检标准为直肠指检异常和/或前列腺特异抗原（PSA）>4 ng/mL。经直肠超声（TRUS）测定前列腺总体积（TPV）。在TRUS引导下进行前列腺活检时，从外周区（PZ）采集10 - 12个样本，从移行区（TZ）额外采集2个样本。TZ的样本立即在液氮中于-70°C冷冻，并使用液相色谱质谱联用仪（LC-MS）运送进行组织雄激素测定。
病理分析显示，45例患者存在前列腺癌（PCa），48例患者不存在。在整个组中，有42名男性前列腺较小（TPV<30 mL），51名男性前列腺增大（TPV≥31 mL）。总体平均tT水平为0.79±0.66 ng/g，而平均tDHT水平为10.27±7.15 ng/g。有PCa和无PCa的前列腺组织中tT和tDHT水平无差异。然而，较大前列腺组织中的tT和tDHT水平显著高于较小前列腺组织（tT分别为1.05±0.75和0.46±0.29 ng/g，tDHT分别为15.0±6.09和4.51±2.75 ng/g）。tT与TPV（r = 0.71）以及tDHT与TPV（r = 0.74）之间存在强相关性。
本研究证实，T和DHT均在增大的前列腺基质中蓄积；蓄积程度与前列腺体积相关。
