Porcaro Antonio B, Petrozziello Aldo, Brunelli Matteo, Migliorini Filippo, Cacciamani Giovanni, De Marchi Davide, de Luyk Nicolo', Tamanini Irene, Caruso Beatrice, Cerruto Maria A, Ghimenton Claudio, Artibani Walter
Clinica Urologica, Ospedale Policlinico ed Ospedale Civile Maggiore, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
Medicina Interna/Endocrinologia, Ospedale Policlinico ed Ospedale Civile Maggiore, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
Asian J Urol. 2016 Jan;3(1):26-32. doi: 10.1016/j.ajur.2015.11.006. Epub 2015 Nov 30.
To investigate potential associations of preoperative total testosterone (TT) with tumor volume (TV) and grade of prostate cancer (PCa).
Patients who were under medications impacting on the hypothalamic-pituitary-adrenal-testis-prostate axis were excluded. TT was measured preoperatively at least 1 month after biopsies and TV was calculated on the removed prostate specimen. Other continuous variables included total prostate specific antigen (PSA), percentage of positive cores (P+) and weight (W) of the removed prostate. Patients were categorized according to the pathologic Gleason score (pGS) in 3 groups (pGS 6, 7 and > 7). Invasion of the seminal vesicles was coded as seminal vesicle invasion (SVI).
The median levels of TT were significantly and increasingly higher from pGS 6 (14.7 nmol/L) to pGS 7 (15.0 nmol/L) and pGS > 7 (18.8 nmol/L). The median values of TV were also detected significantly and increasingly higher from pGS 6 (5.6 mL) to pGS 7 (8.1 mL) and pGS > 7 (14.8 mL). The median preoperative levels of PSA were also increasing from pGS 6 (5.9 μg/L) to pGS 7 (6.2 μg/L) and pGS > 7 (7.7 μg/L). There was a significant and positive correlation of TV to PSA, TT and P+. Multiple linear regression analysis showed that TV was significantly and independently predicted by TT, PSA and P+. High grade PCa (pGS > 7) independently associated with TV, TT, P+ and SVI. The median density values of TT relative to TV (quotient TT/TV) significantly decreased from pGS 6 (2.6 nmol/L/mL) to pGS 7 (1.9 nmol/L/mL) and pGS > 7 (1.4 nmol/L/mL). The median density values of PSA relative to TV (quotient PSA/TV) also significantly decreased from pGS (1.1 μg/L/mL) to pGS 7 (0.7 μg/L/mL) and pGS > 7 (0.6 μg/L/mL).
The investigation shows that TT relates to volume and grade of PCa; moreover, the density of TT relative to TV inversely associates with rate of increase of cancer that depends on the grade of the tumour.
探讨术前总睾酮（TT）与前列腺癌（PCa）肿瘤体积（TV）及分级之间的潜在关联。
排除正在服用影响下丘脑 - 垂体 - 肾上腺 - 睾丸 - 前列腺轴药物的患者。活检后至少1个月进行术前TT测量，并根据切除的前列腺标本计算TV。其他连续变量包括总前列腺特异性抗原（PSA）、阳性核心百分比（P+）及切除前列腺的重量（W）。根据病理Gleason评分（pGS）将患者分为3组（pGS 6、7及>7）。精囊侵犯记为精囊侵犯（SVI）。
TT的中位数水平从pGS 6（14.7 nmol/L）到pGS 7（15.0 nmol/L）及pGS>7（18.8 nmol/L）显著且逐渐升高。TV的中位数也从pGS 6（5.6 mL）到pGS 7（8.1 mL）及pGS>7（14.8 mL）显著且逐渐升高。术前PSA的中位数水平也从pGS 6（5.9 μg/L）到pGS 7（6.2 μg/L）及pGS>7（7.7 μg/L）升高。TV与PSA、TT及P+之间存在显著正相关。多元线性回归分析显示，TT、PSA及P+可显著且独立地预测TV。高级别PCa（pGS>7）与TV、TT、P+及SVI独立相关。TT相对于TV的中位数密度值（商值TT/TV）从pGS 6（2.6 nmol/L/mL）到pGS 7（1.9 nmol/L/mL）及pGS>7（1.4 nmol/L/mL）显著降低。PSA相对于TV的中位数密度值（商值PSA/TV）也从pGS 6（1.1 μg/L/mL）到pGS 7（0.7 μg/L/mL）及pGS>7（0.6 μg/L/mL）显著降低。
研究表明，TT与PCa的体积及分级相关；此外，TT相对于TV的密度与取决于肿瘤分级的癌症增长率呈负相关。
