Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Piazzale Stefani 1, 37126, Verona, Italy.
USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA, USA.
Int Urol Nephrol. 2020 Jul;52(7):1261-1269. doi: 10.1007/s11255-020-02398-x. Epub 2020 Feb 3.
To evaluate the association between basal total testosterone (TT) levels with the European Association of Urology (EAU) risk classes at the time of diagnosis of prostate cancer (PCA).
A retrospective review of prospectively collected data was carried out between November 2014 and March 2018. Preoperative basal TT levels and PSA were measured in 601 consecutive Caucasian patients who were not under androgen deprivation and undergoing surgery at a tertiary referral center. Patients were classified into low (reference group), intermediate- and high-risk/locally advanced classes. The multinomial logistic regression model evaluated associations of TT and other clinical factors with EAU risk classes.
One hundred twenty four patients (24%) were low risk, 316 (52.6%) were intermediate, 199 (16.5%) were high risk and 42 (7%) were locally advanced. Median circulating basal TT levels increased along EAU classes. TT, PSA, percentage of biopsy-positive cores and tumor clinical stage were independently associated with the high-risk class (odds ratio, OR = 1.002; p = 0.030) but were not associated with intermediate-risk or locally advanced PCA when compared to the low-risk class. TT above the median value was an independent predictor of high-risk class PCA.
Basal TT levels are positively associated with low, intermediate and high EAU risk classes. The association is significant for the high-risk class when compared to the low-risk group, but was lost in locally advanced risk class. In PCA patients, high TT serum levels are associated with high-risk disease. Endogenous TT should be considered as a biological marker for assessing EAU PCA risk classes.
评估前列腺癌（PCA）诊断时基础总睾酮（TT）水平与欧洲泌尿外科学会（EAU）风险分级之间的关系。
对 2014 年 11 月至 2018 年 3 月期间前瞻性收集的数据进行了回顾性分析。在一家三级转诊中心，对 601 例未接受雄激素剥夺治疗且接受手术的高加索患者进行了术前基础 TT 水平和 PSA 检测。患者被分为低危（参考组）、中危-高危/局部进展组。多变量逻辑回归模型评估了 TT 和其他临床因素与 EAU 风险分级的相关性。
124 例（24%）患者为低危，316 例（52.6%）为中危，199 例（16.5%）为高危，42 例（7%）为局部进展期。循环基础 TT 水平随 EAU 分级而升高。TT、PSA、活检阳性核心百分比和肿瘤临床分期与高危级独立相关（比值比，OR=1.002；p=0.030），但与低危级相比，与中危级或局部进展期 PCA 无关。TT 高于中位数是高危级 PCA 的独立预测因素。
基础 TT 水平与低、中、高危 EAU 风险分级呈正相关。与低危组相比，高危组的相关性显著，但在局部进展期风险组中则消失。在 PCA 患者中，高 TT 血清水平与高危疾病相关。内源性 TT 应被视为评估 EAU PCA 风险分级的生物学标志物。
