High-grade Prostate Cancer Is Associated With Low Serum Testosterone Levels

Prostate. 2001 Apr;47(1):52-8. doi: 10.1002/pros.1046.

Abstract

Background: The aim of this study was to assess whether low serum testosterone levels in men with newly diagnosed prostate cancer have an association to the endocrine status, prostate-specific antigen (PSA) levels, Gleason score, and androgen receptor expression.

Methods: Besides a full clinical work-up, the following hormones were quantified in men with newly diagnosed prostate cancer by serum analysis: total testosterone, human luteinising hormone (hLH), human follicle stimulating hormone (hFSH), estradiol, and dehydroepiandrostendione (DHEA). In a subgroup of men, androgen receptor expression was determined immunohistochemically.

Results: One hundred and fifty six patients (65.7 +/- 8.5 yrs) with a mean PSA of 29.8 ng/ml (median: 7.4 ng/ml) were analysed. Fifty-two patients (33%) had a partial androgen deficiency (serum testosterone < 3.0 ng/ml). These men had lower hLH (3.3 vs. 5.9 mIU/ml), hFSH (6.2 vs. 8.4 mIU/ml), and estradiol (18.8 vs. 29.1 pg/ml) serum levels. Mean Gleason score was higher (7.4 vs. 6.2) in men with a low serum testosterone, PSA-levels were lower (25.3 vs. 31.9 ng/ml). Mean testosterone levels decreased from 4.1 +/- 1.7 ng/ml in patients with Gleason scores < or = 5 to 2.8 +/- 2.7 ng/ml with Gleason scores > or = 8. Androgen receptor expression was higher in patients with low serum testosterone.

Conclusions: Patients with high Gleason score prostate cancer have lower testosterone and estradiol serum levels. The fact that gonadotropins were lower in parallel suggests a tumor-mediated suppression of the hypothalamic-pituitary-gonadal hormone axis particularly in men with high Gleason score tumours.

MeSH terms

  • Adult
  • Aged
  • Dehydroepiandrosterone / blood
  • Estradiol / blood
  • Follicle Stimulating Hormone / blood
  • Humans
  • Hypothalamo-Hypophyseal System / metabolism
  • Luteinizing Hormone / blood
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prevalence
  • Prostate / chemistry
  • Prostatic Neoplasms / blood*
  • Prostatic Neoplasms / epidemiology
  • Prostatic Neoplasms / pathology*
  • Receptors, Androgen / analysis
  • Testosterone / blood*
  • Testosterone / deficiency

Substances

  • Receptors, Androgen
  • Testosterone
  • Dehydroepiandrosterone
  • Estradiol
  • Luteinizing Hormone
  • Follicle Stimulating Hormone