title: Serum prostate-specific antigen levels reflect the androgen milieu in patients with localized prostate cancer receiving androgen deprivation therapy: Tumor malignant potential and androgen milieu.
abstract: BACKGROUND
  Although androgen deprivation therapy (ADT) has a marked impact on the androgen milieu in vivo and outcomes of prostate cancer (PCa), it remains unclear which parameters reflect the androgen milieu during ADT or whether the milieu is associated with PCa aggressiveness.
  
  
  METHODS
  Seventy-two patients with localized PCa were prospectively studied based on their blood samples before and after ADT for 6 months. Serum androgens and related values were measured.
  
  
  RESULTS
  Before ADT, there was no correlation between the serum prostate-specific antigen (PSA) and androgen levels. After ADT, the serum PSA levels were correlated with each level of serum testosterone, dihydrotestosterone, androstenedione, dehydroepiandrosterone-sulfate (DHEA-S), and 3alpha-diol G (P < 0.010 in all). Before ADT, patients with Gleason score of > or = 8 were likely to have lower serum testosterone levels than those with Gleason score of < or = 6 (P = 0.058). After ADT, conversely, the testosterone levels in patients with Gleason score of > or = 8 appeared to be higher than in those with Gleason score of < or = 6 (P = 0.060). The serum DHEA-S level was correlated with Gleason score before and after ADT (P = 0.050 and P = 0.040, respectively).
  
  
  CONCLUSIONS
  The serum PSA levels well reflect the androgen milieu in localized PCa patients receiving ADT, which can be explained by the Saturation Model and disease control. The androgen milieu in men with high Gleason score PCa is probably less affected by conventional ADT than that in men with low score cancer, which was suggested to be associated with adrenal androgen levels.
authors.affiliation: Division of Urology, Department of Regenerative and Transplant Medicine, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
authors.forename: Itsuhiro
authors.initials: I
authors.lastname: Takizawa
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Nishiyama
authors.forename: Noboru
authors.initials: N
authors.lastname: Hara
authors.forename: Etsuko
authors.initials: E
authors.lastname: Isahaya
authors.forename: Tatsuhiko
authors.initials: T
authors.lastname: Hoshii
authors.forename: Kota
authors.initials: K
authors.lastname: Takahashi
mesh_terms: D000368:Aged; D000728:Androgens / Q000097:blood*; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D016009:Chi-Square Distribution; D005485:Flutamide / Q000627:therapeutic use*; D017273:Goserelin / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000728:Androgens; D018931:Antineoplastic Agents, Hormonal; D017273:Goserelin; D005485:Flutamide; D017430:Prostate-Specific Antigen