title: Serum testosterone as a biomarker for second prostatic biopsy in men with negative first biopsy for prostatic cancer and PSA>4ng/mL, or with PIN biopsy result.
abstract: BACKGROUND
  Data from animal, clinical and prevention studies support the role of androgens in prostate cancer growth, proliferation and progression. Results of serum based epidemiologic studies in humans, however, have been inconclusive. The present study aims to define whether serum testosterone can be used as a predictor of a posi¬tive second biopsy in males considered for re-biopsy.
  
  
  METHODS
  The study included 320 men who underwent a prostatic biopsy in our department from October 2011 until June 2012. Total testosterone, free testos¬terone, bioavailable testosterone and prostate pathology were evaluated in all cases. Patients undergoing a second biopsy were identified and biopsy results were statistically analyzed.
  
  
  RESULTS
  Forty men (12.5%) were assessed with a second biopsy. The diagnosis of the second biopsy was High Grade Intraepithelial Neoplasia in 14 patients (35%) and Prostate Cancer in 12 patients (30%). The comparison of prostatic volume, total testosterone, sex hormone binding globulin, free testosterone, bioavailable testosterone and albumin showed that patients with cancer of the prostate had significantly greater levels of free testosterone (p=0.043) and bioavailable T (p=0.049).
  
  
  CONCLUSIONS
  In our study, higher free testosterone and bioavailable testosterone levels were associated with a cancer diagnosis at re-biopsy. Our results indicate a possible role for free and bioavailable testosterone in predicting the presence of prostate cancer in patients considered for re-biopsy.
authors.affiliation: 2nd Department of Urology, University of Athens, Sismanoglio General Hospital, Athens, Greece.
authors.forename: Alexandros
authors.initials: A
authors.lastname: Fiamegos
authors.affiliation: 2nd Department of Urology, University of Athens, Sismanoglio General Hospital, Athens, Greece.
authors.forename: John
authors.initials: J
authors.lastname: Varkarakis
authors.affiliation: 2nd Department of Urology, University of Athens, Sismanoglio General Hospital, Athens, Greece.
authors.forename: Michael
authors.initials: M
authors.lastname: Kontraros
authors.affiliation: 2nd Department of Urology, University of Athens, Sismanoglio General Hospital, Athens, Greece.
authors.forename: Andreas
authors.initials: A
authors.lastname: Karagiannis
authors.affiliation: 2nd Department of Urology, University of Athens, Sismanoglio General Hospital, Athens, Greece.
authors.forename: Michael
authors.initials: M
authors.lastname: Chrisofos
authors.affiliation: 2nd Department of Urology, University of Athens, Sismanoglio General Hospital, Athens, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Barbalias
authors.affiliation: 2nd Department of Urology, University of Athens, Sismanoglio General Hospital, Athens, Greece.
authors.forename: Charalampos
authors.initials: C
authors.lastname: Deliveliotis
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D001706:Biopsy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011467:Prostate / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood*; D019048:Prostatic Intraepithelial Neoplasia / Q000097:blood* / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000473:pathology*; D012015:Reference Standards; D012016:Reference Values; D012307:Risk Factors; D013739:Testosterone / Q000097:blood*
chemical_list: D014408:Biomarkers, Tumor; D013739:Testosterone; D017430:Prostate-Specific Antigen
keywords: Neoplasms; Biopsy ; Prostate; Testosterone