BERKELEY, CA (UroToday.com) - There has been no consensus on the prostatic tissue androgen concentrations in men with different stages and pathological grades of prostate cancer. In this study, testosterone (T) and dihydrotestosterone (DHT) concentrations in needle biopsy specimens of prostate were examined by liquid chromatography-tandem mass spectrometry (LC-MS/MS).
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At first, to ensure that histological examination and androgen measurement were conducted simultaneously, we measured androgen levels in 90 tissue samples from 10 prostatectomy specimens as prelims. Each specimen was cut into two 2.5-mm-thick mirror-image fragments for androgen assay and histopathological diagnosis, respectively, allowing direct analysis of the relationship between androgen levels and histopathological findings. As results, we found no difference in tissue T and DHT levels between cancerous and noncancerous sections of individual prostate cancer specimens. In our final study, we measured androgen levels in single needle prostate biopsies, but did not confirm if the specimen used for androgen measurement was cancerous or noncancerous. However, the above results suggest that the results of the androgen assay would not be influenced by the presence or absence of cancerous tissue in the sample.
As final examination, we analyzed 196 men diagnosed with prostate cancer. Those patients received systematic needle biopsy, and additionally one needle biopsy from proximal zone was conducted for the purpose of simultaneous determination of T and DHT. T and DHT levels in tissue and blood were compared with Gleason score, clinical stage, and percentage of positive biopsy cores (% positive cores) by multivariate analyses.
Our results confirmed that high T levels in prostate tissue are related to high Gleason score (p=0.041), advanced clinical stage (p=0.002), and high % positive cores (p=0.001). Based on our results, we propose that prostate tissue T level measured by chemical biopsy may be a useful prognostic factor for aiding the design of suitable therapeutic programs for prostate cancer. In our previous study, we first reported that castration-resistant prostate cancer (CRPC) may be predicted by prostate tissue T and DHT levels in a single biopsy specimen obtained before hormonal treatment as a chemical biopsy. Our present finding that high tissue T levels might be associated with poor prognostic factors may thus help predict prostate cancer aggressiveness.
- Shibata Y, Suzuki K, Arai S, Miyoshi Y, Umemoto S, Masumori N, Kamiya N, Ichikawa T, Kitagawa Y, Mizokami A, Sugimura Y, Nonomura N, Sakai H, Honma S, Kubota Y. Impact of pre-treatment prostate tissue androgen content on the prediction of castration-resistant prostate cancer development in patients treated with primary androgen deprivation therapy. Andrology 2013;1(3):505-511.
Yasuhide Miyoshi, MD, PhD as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.
Department of Urology, Yokohama City Medical Center 4-57 Urafune-cho, Minami-ku, Yokohama 232-0024 Japan