title: Association between the dihydrotestosterone level in the prostate and prostate cancer aggressiveness using the Gleason score.
abstract: OBJECTIVE
  To our knowledge the association between dihydrotestosterone in the prostate and prostate cancer aggressiveness has not yet been elucidated. We analyzed dihydrotestosterone levels in the prostate and Gleason score in patients diagnosed with clinically localized prostate cancer.
  
  
  METHODS
  A total of 81 patients with suspected prostate cancer underwent prostate biopsy. Serum samples were collected before biopsy. Dihydrotestosterone levels in prostatic tissue and serum were analyzed using liquid chromatography/electrospray ionization-mass spectrometry after polar derivatization.
  
  
  RESULTS
  A total of 47 patients were diagnosed with stages T1 to T3N0M0 prostate cancer and 34 were diagnosed with no malignancy. Of the 47 patients 32 had a Gleason score of 6 or less and 15 had a score of 7 to 10. Dihydrotestosterone in prostatic tissue in patients with Gleason score 7 to 10 disease was significantly lower than in those with Gleason score 6 or less disease (p = 0.025). Gleason score correlated with the testosterone-to-serum dihydrotestosterone ratio (rs = 0.329, p = 0.038).
  
  
  CONCLUSIONS
  Patients with Gleason score 7 to 10 prostate cancer have low dihydrotestosterone in the prostate, although there were no significant differences between patients with Gleason score 7 to 10 vs 6 or less prostate cancer with respect to serum androgens. Low dihydrotestosterone in cases of aggressive prostate cancer is probably sufficient to activate androgen receptor expression and propagate tumor growth.
authors.affiliation: Division of Urology, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan. nisiyama@med.niigata-u.ac.jp
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Nishiyama
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Ikarashi
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Hashimoto
authors.forename: Kazuya
authors.initials: K
authors.lastname: Suzuki
authors.forename: Kota
authors.initials: K
authors.lastname: Takahashi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D013196:Dihydrotestosterone / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011467:Prostate / Q000378:metabolism* / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000378:metabolism* / Q000473:pathology*; D045165:Testosterone Congeners / Q000097:blood
chemical_list: D045165:Testosterone Congeners; D013196:Dihydrotestosterone; D017430:Prostate-Specific Antigen