Kitahara S, Yoshida K, Ishizaka K, Kageyama Y, Kawakami S, Tsujii T, Oshima H
Department of Urology, Tokyo Medical and Dental University School of Medicine, Japan.
Endocr J. 1997 Aug;44(4):527-32. doi: 10.1507/endocrj.44.527.
Serum levels of LH, FSH and testosterone (T) were measured by radioimmunoassays in 36 patients with advanced prostate cancer before and during androgen ablation therapies. Both leuprolide acetate (LH-RH agonist: LHRH-A) and diethylstilbestrol diphosphate (DES-DP) administration decreased serum LH significantly to an undetectable level (LHRH-A: P < 0.01, DES-DP: P < 0.05). LHRH-A and DES-DP diminished serum FSH to 20% of the pre-treatment level (P < 0.005) and to an undetectable level (P < 0.001), respectively. LHRH-A and DES-DP decreased serum T to the castration level and an undetectable level, respectively (P < 0.001). Serum levels of the same 3 hormones before and after DES-DP administration were measured in 8 patients who received DES-DP after LHRH-A treatment or castration because of relapse of the disease. DES-DP lowered serum FSH further than LHRH-A to an undetectable level (P < 0.005) and diminished T further than previous treatments to an undetectable level (P < 0.05 vs. LHRH-A, P < 0.01 vs. castration). These results suggest that 1) DES-DP is able to reduce T production from extra-testicular site(s), and achieve the minimal serum T level, and 2) this DES-DP action appears to be one of the mechanisms of the effectiveness of the estrogen on refractory prostate cancer after castration or LHRH-A. In addition, basal (independent of LH-RH) FSH secretion in elderly men is about 20% of total FSH secretion and DES-DP inhibits the basal FSH secretion at the level of the pituitary.
采用放射免疫分析法，对36例晚期前列腺癌患者在雄激素剥夺治疗前及治疗期间检测血清促黄体生成素（LH）、促卵泡生成素（FSH）和睾酮（T）水平。醋酸亮丙瑞林（促性腺激素释放激素激动剂：LHRH - A）和己烯雌酚二磷酸酯（DES - DP）给药后，血清LH均显著降低至检测不到的水平（LHRH - A：P < 0.01，DES - DP：P < 0.05）。LHRH - A和DES - DP分别将血清FSH降至治疗前水平的20%（P < 0.005）和检测不到的水平（P < 0.001）。LHRH - A和DES - DP分别将血清T降至去势水平和检测不到的水平（P < 0.001）。对8例因疾病复发在LHRH - A治疗或去势后接受DES - DP治疗的患者，检测其DES - DP给药前后上述3种激素的血清水平。DES - DP比LHRH - A进一步降低血清FSH至检测不到的水平（P < 0.005），比之前的治疗进一步降低T至检测不到的水平（与LHRH - A相比，P < 0.05；与去势相比，P < 0.01）。这些结果表明：1）DES - DP能够减少睾丸外部位的T生成，并达到最低血清T水平；2）DES - DP的这种作用似乎是雌激素对去势或LHRH - A治疗后难治性前列腺癌有效的机制之一。此外，老年男性基础（独立于LH - RH）FSH分泌约占总FSH分泌的20%，DES - DP在垂体水平抑制基础FSH分泌。
