The change in the dihydrotestosterone level in the prostate before and after androgen deprivation therapy in connection with prostate cancer aggressiveness using the Gleason score.
OBJECTIVE
We investigated the change in dihydrotestosterone in the prostate during androgen deprivation therapy in connection with prostate cancer aggressiveness using the Gleason score.


METHODS
A total of 28 patients with clinically localized prostate cancer who were treated with androgen deprivation therapy for 6 months were enrolled in this study. Dihydrotestosterone in the prostate and serum were analyzed using liquid chromatography/electrospray ionization-mass spectrometry after polar derivatization before and after androgen deprivation therapy.


RESULTS
The change in dihydrotestosterone during androgen deprivation therapy in the prostate with Gleason score 7 to 10 prostate cancer was significantly smaller than that in the prostate with Gleason score 6 or less (p = 0.016). There were no significant differences between patients with Gleason score 7 to 10 prostate cancer and patients with Gleason score 6 or less in dihydrotestosterone in the prostate, in serum androgens and in serum androgen ratios before and after androgen deprivation therapy.


CONCLUSIONS
Low dihydrotestosterone in the prostate is probably sufficient to propagate the growth of aggressive prostate cancer. Furthermore, the prostate with aggressive prostate cancer can produce androgens from adrenal precursors more autonomously than the prostate with nonaggressive prostate cancer under a low testosterone environment with testicular suppression.
Nishiyama
Tsutomu
T
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
Ikarashi
Toshihiko
T
Hashimoto
Yutaka
Y
Wako
Koichi
K
Takahashi
Kota
K
D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000097:blood; D013196:Dihydrotestosterone / Q000097:blood*; D018450:Disease Progression; D005485:Flutamide / Q000627:therapeutic use*; D017273:Goserelin / Q000627:therapeutic use*; D006801:Humans; D016729:Leuprolide / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D009919:Orchiectomy; D011379:Prognosis; D011467:Prostate / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D013739:Testosterone / Q000097:blood
D000726:Androgen Antagonists; D014408:Biomarkers, Tumor; D013196:Dihydrotestosterone; D017273:Goserelin; D013739:Testosterone; D005485:Flutamide; D017430:Prostate-Specific Antigen; D016729:Leuprolide