title: Investigative clinical study on prostate cancer part VII: prolactin and the pituitary-testis-prostate axis at the time of initial diagnosis and subsequent cluster selection of the patient population.
abstract: OBJECTIVE
  To evaluate prolactin (PRL) physiopathology along the pituitary-testis-prostate axis at the time of initial diagnosis of prostate cancer in relation to the available clinical variables and to the subsequent cluster selection of the patient population.
  
  
  METHODS
  The study involved 100 individuals diagnosed with prostate cancer. Age, percentage of positive cores at transrectal ultrasound scan biopsy (P+), biopsy Gleason score (BGS), PRL, luteinizing hormone (LH), follicle stimulating hormone (FSH), total testosterone (TT), free testosterone (FT) and prostate-specific antigen (PSA) were the continuous clinical variables. All patients had histologically proven carcinoma of the prostate and had not previously received hormonal manipulations. Correlation and multiple linear regression analysis of the the variables along the pituitary-testis-prostate cancer axis was performed. The prostate cancer population was clustered according to the PRL/P+ ratio into group A (4.20≤PRL/P+ ≤20), B (20<PRL/P+ ≤44) and C (44<PRL/P+≤157.83). Correlation, multiple linear regression and analysis of variance of the clustered population along the pituitary-testis-prostate cancer axis was computed.
  
  
  RESULTS
  At diagnosis of prostate cancer, pituitary hormones were significantly correlated to FT (PRL, FSH, LH) and to PSA (FSH, LH); also close to significance was the correlation of both PRL and LH to P+ (p=0.07). On multiple linear regression analysis only, PRL was independently predicted by P+ (p=0.02), while PSA independently predicted both FSH (p=0.03) and LH (p=0.01). PRL was significantly correlated to P+ in the prostate cancer population clustered according to the PRL/P+ ratio into groups A, B and C which significantly differed for PRL (p=0.002), P+ (p<0.0001) and BGs (p=0.0001).
  
  
  CONCLUSIONS
  In the prostate cancer population at diagnosis and along the pituitary-testis-prostate axis, PRL is significantly correlated to P+; moreover, PRL is also independently predicted by P+. Because of the high correlation between PRL and P+, the prostate cancer population at diagnosis might be clustered according to the PRL/P+ ratio into groups A, B and C, which, as a theory, might express prognostic potential for clinical applications. However, confirmatory studies are needed.
authors: Department of Urology, University Integrated Hospitals, Civil Major Hospital, Verona, Italy. drporcaro@yahoo.com
authors: Antonio B
authors: AB
authors: Porcaro
authors: Claudio
authors: C
authors: Ghimenton
authors: Aldo
authors: A
authors: Petrozziello
authors: Filippo
authors: F
authors: Migliorini
authors: Mario
authors: M
authors: Romano
authors: Teodoro
authors: T
authors: Sava
authors: Beatrice
authors: B
authors: Caruso
authors: Claudio
authors: C
authors: Cocco
authors: Stefano Zecchinini
authors: SZ
authors: Antoniolli
authors: Vincenzo
authors: V
authors: Lacola
authors: Emanuele
authors: E
authors: Rubilotta
authors: Carmelo
authors: C
authors: Monaco
authors: Luigi
authors: L
authors: Comunale
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D018579:Patient Selection; D010902:Pituitary Gland / Q000473:pathology*; D010907:Pituitary Hormones / Q000097:blood; D011379:Prognosis; D011388:Prolactin / Q000097:blood*; D011467:Prostate / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood* / Q000175:diagnosis*; D013737:Testis / Q000473:pathology*; D013739:Testosterone / Q000097:blood
chemical_list: D010907:Pituitary Hormones; D013739:Testosterone; D011388:Prolactin; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D017430:Prostate-Specific Antigen