Ballerini P, Oriana S, Duca P, Martinetti A, Venturelli E, Ferrari L, Dolci S, Secreto G
National Cancer Institute of Milan, Italy.
Breast Cancer Res Treat. 1993;26(1):1-6. doi: 10.1007/BF00682694.
We investigated the role of urinary testosterone levels as a marker of risk of recurrent disease in 113 operable breast cancer patients (70 premenopausal, 43 postmenopausal). Twenty-four-hour urine collections for testosterone measurement were obtained before surgical treatment, between 20-40 days thereafter, and then every 6 months for 5 years. The cutoff values to separate 'high testosterone (A+)' from 'normal testosterone (A-)' were 8.0 micrograms/24 h in premenopause and 4.9 micrograms/24 h in postmenopause. Urinary testosterone levels were considered high when they exceeded the cutoff value in at least 2 of the first 3 measurements (pretreatment, post-treatment, 6 months) of each patient. According to the aforementioned criterion, 33 patients (29.2%) had high testosterone levels, which were associated to axillary node involvement in 16 patients. Thirteen of the latter relapsed during the 5-year follow-up period (5/7 in premenopause, 8/9 in postmenopause). Relapse-free survival (RFS) curves were drawn only for node-positive patients owning to the small number of recurrences observed in the node-negative group. In premenopausal node-positive patients, RFS was significantly different for patients presenting high and normal urinary testosterone levels (77% vs 28%, respectively; logrank test, p < 0.006). In postmenopausal node-positive patients, RFS was also different between the two groups (54% vs 11% in 'high' and 'normal' excretors, respectively) but the difference was not statistically significant. The present findings suggest that urinary testosterone is a prognostic indicator of early breast cancer recurrence in node-positive patients.
我们研究了尿睾酮水平作为113例可手术乳腺癌患者（70例绝经前，43例绝经后）疾病复发风险标志物的作用。在手术治疗前、术后20 - 40天以及之后每6个月共5年的时间里，收集患者24小时尿液以测量睾酮水平。区分“高睾酮（A+）”和“正常睾酮（A-）”的临界值在绝经前为8.0微克/24小时，绝经后为4.9微克/24小时。当每位患者在前3次测量（治疗前、治疗后、6个月）中至少有2次超过临界值时，尿睾酮水平被认为较高。根据上述标准，33例患者（29.2%）尿睾酮水平较高，其中16例与腋窝淋巴结受累相关。在这16例患者中，有13例在5年随访期内复发（绝经前5/7，绝经后8/9）。由于在淋巴结阴性组中观察到的复发病例数较少，仅为淋巴结阳性患者绘制了无复发生存（RFS）曲线。在绝经前淋巴结阳性患者中，尿睾酮水平高和正常的患者RFS有显著差异（分别为77%和28%；对数秩检验，p < 0.006）。在绝经后淋巴结阳性患者中，两组之间的RFS也存在差异（“高”排泄者和“正常”排泄者分别为54%和11%），但差异无统计学意义。目前的研究结果表明，尿睾酮是淋巴结阳性患者早期乳腺癌复发的预后指标。
