title: Anogenital Distance, a Biomarker of Prenatal Androgen Exposure Is Associated With Prostate Cancer Severity.
abstract: Anogenital distance (AGD), the distance from the centre of the anus to the genitals, is a sexually dimorphic phenotype in mammals. Experimental studies have shown that AGD is a biomarker of prenatal androgen exposure during the masculinisation period of development. The aim of this study is to assess the relationship between anogenital distance (AGD), as an indirect marker of prenatal hormonal environment, and prostate cancer (PCa) severity.
  
  
  
  We conducted a cross-sectional study with a total of 120 PCa patients with confirmed biopsy of the tumour from April 2007 to July 2015. Two variants of the anogenital distance were assessed, from the anus to the posterior base of the scrotum (AGDAS) and to the cephalad insertion of the penis (AGDAP). We compared differences in groups to evaluate the association between AGD measurements and severity of the preoperative biopsy and clinical scores.
  
  
  
  Longer AGDASwas significantly associated with the highest Gleason score (P = 0.015) and D'Amico nomogram (P = 0.048). In contrast, no statistical differences were found in the AGDAPand severity of the preoperative biopsy.
  
  
  
  These findings are consistent with the hypothesis that a higher prenatal androgen exposure is associated with higher severity of PCa. Prostate 77: 406-411, 2017. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Division of Preventive Medicine and Public Health, University of Murcia School of Medicine, Espinardo (Murcia), IMIB-Arrixaca, Spain.|Department of Preventive Medicine, "Reina Sofia", University General Hospital, Murcia, Spain.
authors.forename: Ana B
authors.initials: AB
authors.lastname: Maldonado-Cárceles
authors.affiliation: Department of Urology, "Rafael Mendez", University Hospital, Lorca, Murcia, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Sánchez-Rodríguez
authors.affiliation: Department of Preventive Medicine, "Reina Sofia", University General Hospital, Murcia, Spain.
authors.forename: Eva M
authors.initials: EM
authors.lastname: Vera-Porras
authors.affiliation: Department of Preventive Medicine, "Reina Sofia", University General Hospital, Murcia, Spain.
authors.forename: Julián J
authors.initials: JJ
authors.lastname: Árense-Gonzalo
authors.affiliation: Department of Urology, "Reina Sofia", University General Hospital, Murcia, Spain.
authors.forename: Julián
authors.initials: J
authors.lastname: Oñate-Celdrán
authors.affiliation: Department of Urology, "Reina Sofia", University General Hospital, Murcia, Spain.
authors.forename: Paula
authors.initials: P
authors.lastname: Samper-Mateo
authors.affiliation: Department of Urology, "Reina Sofia", University General Hospital, Murcia, Spain.
authors.forename: Damián
authors.initials: D
authors.lastname: García-Escudero
authors.affiliation: Department of Urology, "Reina Sofia", University General Hospital, Murcia, Spain.
authors.forename: Marcos
authors.initials: M
authors.lastname: Torres-Roca
authors.affiliation: Department of Anatomical Pathology, "Reina Sofia", University General Hospital, Murcia, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Martínez-Díaz
authors.affiliation: Division of Preventive Medicine and Public Health, University of Murcia School of Medicine, Espinardo (Murcia), IMIB-Arrixaca, Spain.
authors.forename: Jaime
authors.initials: J
authors.lastname: Mendiola
authors.affiliation: Division of Preventive Medicine and Public Health, University of Murcia School of Medicine, Espinardo (Murcia), IMIB-Arrixaca, Spain.|Department of Preventive Medicine, "Reina Sofia", University General Hospital, Murcia, Spain.
authors.forename: Alberto M
authors.initials: AM
authors.lastname: Torres-Cantero
mesh_terms: D000368:Aged; D001003:Anal Canal / Q000033:anatomy & histology*; D000728:Androgens / Q000009:adverse effects* / Q000378:metabolism; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010413:Penis / Q000033:anatomy & histology*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000378:metabolism / Q000473:pathology; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000209:etiology / Q000378:metabolism; D012720:Severity of Illness Index
chemical_list: D000728:Androgens
keywords: D'Amico nomogram; anogenital distance; gleason score; preoperative PSA; prostate cancer