title: Estrogens, testosterone and sex hormone binding globulin in relation to liver cancer in men.
abstract: OBJECTIVE
  Liver disease in men has been associated with an imbalance of serum estradiol and testosterone. We have evaluated whether serum estradiol and testosterone levels are altered in male liver cancer patients as a result of a specific effect of the disease or because of the associated liver damage.
  
  
  METHODS
  We have performed a hospital-based case-control study in Greece. The study subjects were all men; 73 patients with hepatocellular carcinoma (HCC), 25 with metastatic liver cancer (MLC) patients and 111 control subjects. Serum estradiol, testosterone and sex hormone binding globulin (SHBG) levels were measured for each subject. Data were analyzed by multiple linear regression.
  
  
  RESULTS
  Mean serum estradiol levels were significantly higher among HCC patients as well as among patients with MLC compared to controls. Mean serum testosterone levels were significantly lower among HCC patients as well as among patients with MLC compared to controls. The mean SHBG levels did not differ significantly between the groups. After controlling for the degree of liver damage, the elevated serum estradiol and reduced serum testosterone levels among HCC and MLC patients were no longer significant.
  
  
  CONCLUSIONS
  Changes in sex steroid levels among patients with liver damage are due to the liver damage per se and not to specific disease processes.
authors.affiliation: Department of Epidemiology, Harvard School of Public Health, Boston, Mass., USA. hkuper@hsph.harvard.edu
authors.forename: H
authors.initials: H
authors.lastname: Kuper
authors.forename: C
authors.initials: C
authors.lastname: Mantzoros
authors.forename: P
authors.initials: P
authors.lastname: Lagiou
authors.forename: A
authors.initials: A
authors.lastname: Tzonou
authors.forename: R
authors.initials: R
authors.lastname: Tamimi
authors.forename: L
authors.initials: L
authors.lastname: Mucci
authors.forename: V
authors.initials: V
authors.lastname: Benetou
authors.forename: E
authors.initials: E
authors.lastname: Spanos
authors.forename: S O
authors.initials: SO
authors.lastname: Stuver
authors.forename: D
authors.initials: D
authors.lastname: Trichopoulos
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000473:pathology / Q000821:virology; D016022:Case-Control Studies; D004958:Estradiol / Q000097:blood*; D016174:Hepacivirus / Q000472:pathogenicity; D006515:Hepatitis B virus / Q000472:pathogenicity; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood* / Q000473:pathology / Q000821:virology; D008297:Male; D008875:Middle Aged; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism*; D013739:Testosterone / Q000097:blood*
chemical_list: D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; D004958:Estradiol