Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Urology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
Clin Genitourin Cancer. 2019 Jun;17(3):e387-e393. doi: 10.1016/j.clgc.2019.03.021. Epub 2019 Apr 6.
Testosterone suppression in serum during androgen deprivation therapy (ADT) can affect the oncologic outcome of ADT. Although genetic variants in sex hormone-binding globulin (SHBG) were reported to be correlated with serum testosterone level, the association with serum testosterone during ADT remains unclear. Therefore, this study investigated the impact of a missense polymorphism in the SHBG gene among men treated with primary ADT for metastatic prostate cancer.
This study included 104 Japanese men with metastatic prostate cancer. The association of SHBG gene polymorphism (rs6259, D356N) with clinicopathologic parameters including serum testosterone levels during ADT, as well as prognosis, including progression-free survival and overall survival, was examined.
The serum testosterone levels during ADT were comparable between men carrying the homozygous wild-type (GG) and heterozygous/homozygous variant (GA/AA) in the SHBG gene. When adjusted for age, Gleason score, initial prostate-specific antigen, and clinical T-stage, the heterozygous/homozygous variant (GA/AA) in the SHBG gene was associated with a higher risk of progression (hazard ratio, 2.20; 95% confidence interval, 1.10-4.18; P = .027) and any-cause death (hazard ratio, 3.21; 95% confidence interval, 1.31-7.35; P = .012).
This study suggested genetic variation in SHBG (rs6259) might be an independent prognostic biomarker among men treated with primary ADT for metastatic prostate cancer.
去势治疗(ADT)期间血清中睾酮的抑制作用会影响 ADT 的肿瘤学结果。尽管已有研究报道,性激素结合球蛋白(SHBG)中的遗传变异与血清睾酮水平相关,但 ADT 期间血清睾酮与这些遗传变异的相关性尚不清楚。因此,本研究调查了 SHBG 基因中一个错义突变(rs6259,D356N)对接受原发 ADT 治疗的转移性前列腺癌患者的影响。
本研究纳入了 104 名接受原发 ADT 治疗的转移性前列腺癌日本男性患者。研究分析了 SHBG 基因突变(rs6259,D356N)与包括 ADT 期间血清睾酮水平在内的临床病理参数的相关性,以及与无进展生存期和总生存期等预后的相关性。
在携带 SHBG 基因纯合野生型(GG)和杂合/纯合变异型(GA/AA)的男性中,ADT 期间的血清睾酮水平无显著差异。在校正年龄、Gleason 评分、初始前列腺特异性抗原和临床 T 分期后,SHBG 基因中的杂合/纯合变异型(GA/AA)与更高的进展风险(风险比,2.20;95%置信区间,1.10-4.18;P =.027)和任何原因死亡风险(风险比,3.21;95%置信区间,1.31-7.35;P =.012)相关。
本研究表明,SHBG(rs6259)的遗传变异可能是接受原发 ADT 治疗的转移性前列腺癌患者的独立预后生物标志物。