Choi Se Young, Chi Byung Hoon, Lee Wonchul, Lim Bumjin, You Dalsan, Kim Choung-Soo
Department of Urology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, 102 Heukseok-ro, Dongjak-gu, Seoul 06973, Korea.
Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea.
J Clin Med. 2020 Apr 29;9(5):1281. doi: 10.3390/jcm9051281.
This study analyzed the association between sex hormone concentrations and stage/condition in patients with prostate cancer.
The concentrations of sex hormones, including testosterone (total, free, and bioavailable), sex hormone-binding globulin (SHBG), luteinizing hormone (LH), and follicle-stimulating hormone (FSH), were measured in 415 patients diagnosed with prostate cancer. Differences in serum hormone concentrations after receiving androgen deprivation therapy (ADT) and after withdrawal from ADT were evaluated. Pathologic characteristics were assessed in the 225 patients unexposed to ADT with a history of radical prostatectomy. Logistic regression analysis was performed to identify factors predictive of unfavorable pathology (Grade ≥3, ≥T3a, or N1).
Of the 415 prostate cancer patients, 130 (31.3%) were assessed before treatment, 171 (41.2%) after surgery, 35 (8.4%) after biochemical recurrence, and 59 (14.2%) during ADT, whereas 20 (4.8%) had castration-resistant prostate cancer. FSH was significantly lower after compared to before prostatectomy (3.229 ± 4.486 vs. 5.941 ± 7.044 mIU/mL, < 0.001). LH, FSH, and testosterone decreased significantly 3 months after starting ADT, but increased 3 months after ADT withdrawal, whereas SHBG was unchanged. Multivariate analysis showed that high LH (odds ratio [OR]: 1.59, 95% confidence interval [CI]: 1.03-2.47, = 0.0376) and prostate-specific antigen (PSA) (OR: 1.13, 95% CI: 1.03-1.24, = 0.0133) concentrations were significantly associated with a high risk of unfavorable pathology.
Sex hormones, including LH, FSH, and testosterone, were affected by ADT. The FSH level decreased after radical prostatectomy. High baseline LH concentration in patients unexposed to ADT was associated with an unfavorable pathology.
本研究分析了前列腺癌患者性激素浓度与分期/病情之间的关联。
对415例诊断为前列腺癌的患者测定了性激素浓度，包括睾酮（总睾酮、游离睾酮和生物可利用睾酮）、性激素结合球蛋白（SHBG）、促黄体生成素（LH）和促卵泡生成素（FSH）。评估了接受雄激素剥夺治疗（ADT）后及停止ADT后血清激素浓度的差异。对225例有前列腺癌根治术病史且未接受ADT的患者的病理特征进行了评估。进行逻辑回归分析以确定预测不良病理（Gleason分级≥3级、≥T3a或N1）的因素。
在415例前列腺癌患者中，130例（31.3%）在治疗前进行了评估，171例（41.2%）在手术后进行了评估，35例（8.4%）在生化复发后进行了评估，59例（14.2%）在ADT期间进行了评估，而20例（4.8%）患有去势抵抗性前列腺癌。与前列腺癌根治术前相比，FSH显著降低（3.229±4.486 vs. 5.941±7.044 mIU/mL，P<0.001）。开始ADT后3个月，LH、FSH和睾酮显著降低，但停止ADT后3个月升高，而SHBG无变化。多变量分析显示，高LH（比值比[OR]：1.59，95%置信区间[CI]：1.03 - 2.47，P = 0.0376）和前列腺特异性抗原（PSA）（OR：1.13，95%CI：1.03 - 1.24，P = 0.0133）浓度与不良病理高风险显著相关。
包括LH、FSH和睾酮在内的性激素受ADT影响。前列腺癌根治术后FSH水平降低。未接受ADT的患者基线LH浓度高与不良病理相关。
