High serum dihydrotestosterone examined by ultrasensitive LC-MS/MS as a predictor of benign prostatic hyperplasia or Gleason score 6 cancer in men with prostate-specific antigen levels of 3-10 ng/mL.
There has been no consensus on the role of serum androgen concentrations in prostate cancer detection in men with prostate-specific antigen levels of 3-10 ng/mL. In this study, testosterone and dihydrotestosterone concentrations in blood were examined by a newly developed method using ultrasensitive liquid chromatography with two serially linked mass spectrometers (LC-MS/MS). We investigated the correlation between serum androgen levels and Gleason scores at biopsy. We analyzed data of 157 men with a total prostate-specific antigen range of 3-10 ng/mL who underwent initial systematic prostate needle biopsy for suspected prostate cancer between April 2000 and July 2003. Peripheral blood testosterone and dihydrotestosterone concentrations were determined by LC-MS/MS. Blood levels of testosterone and dihydrotestosterone were compared with pathological findings by multivariate analyses. Median values of prostate-specific antigen and prostate volume measured by ultrasound were 5.7 ng/mL and 31.4 cm3, respectively. Benign prostatic hyperplasia was diagnosed in 97 patients (61.8%), and prostate cancer was diagnosed in 60 (38.2%) patients, including 31 (19.7%) patients with a Gleason score of 6 and 29 (18.5%) patients with a Gleason score of 7-10. Median values of testosterone and dihydrotestosterone in blood were 3798.7 and 371.7 pg/mL, respectively. There was a strong correlation between serum testosterone and dihydrotestosterone. In multivariate analysis, age, prostate volume, and serum dihydrotestosterone were significant predictors of benign prostatic hyperplasia or prostate cancer with a Gleason score of 6. The area under the receiver operating characteristics curve for age, prostate volume, and serum dihydrotestosterone were 0.67, 0.67, and 0.67, respectively . We confirmed that high dihydrotestosterone blood levels can predict benign prostatic hyperplasia or prostate cancer with a Gleason score of 6 in men with prostate-specific antigen levels of 3-10 ng/mL.
Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.|Department of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan.
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Miyoshi
Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.|Department of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan.
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Uemura
Department of Urology, Gunma University Graduate School of Medicine, Maebashi, Japan.
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Suzuki
Department of Urology, Gunma University Graduate School of Medicine, Maebashi, Japan.
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Shibata
ASKA Pharma Medical Co. Ltd., Kawasaki, Japan.
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Honma
Department of Urology and Pathology, Kanagawa Cancer Center, Yokohama, Japan.
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Harada
Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
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Kubota
D000230:Adenocarcinoma / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D000368:Aged; D000369:Aged, 80 and over; D002853:Chromatography, Liquid; D013196:Dihydrotestosterone / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D011467:Prostate / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood*; D011470:Prostatic Hyperplasia / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D053719:Tandem Mass Spectrometry; D013739:Testosterone / Q000097:blood
D013196:Dihydrotestosterone; D013739:Testosterone; D017430:Prostate-Specific Antigen
Gleason score; androgens; dihydrotestosterone; prostate cancer; testosterone