Sex Hormone-Binding Globulin Concentration in Patients with Prostate Cancer Treated with Radical Prostatectomy
Journal of Urologic Oncology 2014³â 12±Ç 1È£ p.29 ~ p.37
½É¸í¼±(Shim Myung-Sun) - University of Ulsan College of Medicine Asan Medical Center Department of Urology
¼Û丰(Song Che-Ryn) - University of Ulsan College of Medicine Asan Medical Center Department of Urology
¹ÚÁøÅÃ(Park Jin-Taek) - University of Ulsan College of Medicine Asan Medical Center Department of Urology
°¹Î±Ô(Kang Min-Kyu) - University of Ulsan College of Medicine Asan Medical Center Department of Urology
À̹«¼º(Lee Moo-Song) - University of Ulsan College of Medicine Department of Clinical Epidemiology and Biostatistics
±èÁ¾¿ø(Kim Jong-Won) - Korea Cancer Center Hospital Department of Urology
¾ÈÇÑÁß(Ahn Han-Jong) - University of Ulsan College of Medicine Asan Medical Center Department of Urology
Abstract
Purpose: We aimed to identify the relationship between the serum testosterone (TS) axis and the clinically localized prostate cancer and to evaluate the changes in hormone concentrations after radical prostatectomy (RP).
Materials and Methods: Blood samples were drawn from 699 patients with prostate cancer before and after RP, without hormone or radiation therapy, and from 700 age-matched healthy men between 7:00 and 9:00 A.M., and their serum concentrations of total TS and sex hormone-binding globulin (SHBG) were measured.
Results: Patients with prostate cancer had lower mean SHBG (55.8¡¾22.0 vs. 61.4¡¾24.2 nmol/L) and higher mean free TS (FT) (7.1¡¾2.5 vs. 6.3¡¾2.6 ng/dl), bioavailable TS (BAT) (158.2¡¾55.2 vs. 138.1¡¾56.5 ng/dl), and free TS index (FTI) (31.3¡¾12.0 vs. 27.1¡¾11.6) than healthy controls (all, p£¼0.001), while total TS did not differ. Following RP, patients with prostate cancer showed significant increases in SHBG (65.6¡¾26.3 vs. 56.3¡¾21.6 nmol/L) and subsequent decreases in FT (6.4¡¾4.4 vs. 7.2¡¾2.5 ng/dl), BAT (138.2¡¾50.3 vs. 158.7¡¾55.3 ng/dl), and FTI (26.5¡¾11.1 vs. 31.2¡¾11.7) (all, p£¼0.001), whereas total TS remained unchanged. Preoperative SHBG concentration was significantly lower in patients with pathologic Gleason score (GS) £¼7 than in those with GS ¡Ã7 (p£¼0.001). SHBG was an independent predictor of pathologic GS £¼7 (p=0.003), along with preoperative prostatic specific antigen (PSA) concentration and biopsy GS.
Conclusions: Prostate cancer influences the sex hormonal axis, modulating SHBG concentration and increasing the utilization of bioactive TS.
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Prostate cancer, Testosterone, Sex hormone-binding globulin, Prostatectomy
KMID :
1001020140120010029
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