Hormonal pattern in prostatic cancer I. Correlation with local extent of tumour, presence of metastases and grade of differentiation

Abstract

In 32 subjects with histologically and/or cytologically verified prostatic cancer the hormonal pattern was studied by assaying 18 plasma and urinary hormones or groups of hormones. The tumours were classified according to the UICC classification system and the hormone values were correlated to the local extent of the tumour (T classification), the presence of metastases (M classification) and the differentiation grade (G classification). It was found that patients with metastases had significantly higher plasma oestradiol and lower testosterone/oestradiol and testosterone/oestrone plus oestradiol ratios as compared to those subjects without metastases. In subjects with moderately or poorly differentiated tumours plasma oestrone + oestradiol was significantly higher and the testosterone/oestrone + oestradiol ratio was significantly lower than in the subjects with well differentiated tumours. In the various TNM classification groups no obvious trends were found with regard to urinary hormones and no significant differences between the groups for plasma FSH, LH, prolactin, progesterone and cortisol were observed. It is concluded that in more advanced cases with metastatic cancer and when tumours are less well differentiated the androgen/oestrogen ratio may be decreased. These alterations have no diagnostic significance because of great overlapping of individual results between the various groups of patients.Studies on urinary and plasma hormones in human subjects with prostatic cancer have revealed controversial results and there does not seem to be any clear difference in sex hormone production or metabolism or sex hormone binding globulin bind¬ ing capacity (SHBG) between these subjects and normal individuals other than possible differences due to changes in the general condition of the carcinoma patients (for literature see Voigt & Krieg 1978). The results obtained would suggest that at least the sex hormone pattern prevailing before the development of cancer has no influence on the formation of the cancer. However, recent results showing significantly different hormonal pattern in two histological groups of cancer (Bartsch et al.1977a) seem to suggest that the hormonal milieu could influence the further development of the cancer cells.In order to study the correlation of the hormonal pattern in prostatic cancer with local extent of tumour, presence of métastases and grade of dif¬ ferentiation, 18 hormones or groups of hormones were assayed in the plasma and urine of patients classified according to UICC classification system. The results indicate that a low plasma testosterone/ oestrogen (T/Oe) ratio is typical for patients with poorly and moderately differentiated advanced prostatic carcinoma. Materials and Methods SubjectsThe series consisted of 32 patients with histologically and/or cytologically verified prostatic cancer (mean age A preliminary report of these results was presented at the IXth Meeting of the International Study Group for Steroid Hormones in Rome, 5 -7 December 1979 (Rannikkoetal. 1979).

Estrone sulfate (E1S), a prognosis marker for tumor aggressiveness in prostate cancer (PCa)

“…Immunoassay results for E 2 were compared with those obtained using the GC/MS method, and those for E 1 S using LC/MS/MS [33]. We determined E 1 by GC/MS [34], which was not the case for some previously published plasma E 1 assays involving PCa patients [2][3][4]7,12,35].…”

“…Over the years, numerous studies have attempted to evaluate the role of androgens, particularly testosterone, in PCa and BPH [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. However, few studies have addressed the role of estrogens (estradiol and estrone) in these pathologies, due to difficulties encountered in measuring their low circulating levels in males.…”

Pretreatment plasma testosterone and estradiol levels in patients with locally advanced or metastasized prostatic cancer

“…Measurement of plasma T, E2, and SHBG levels was performed as described previously [21][22][23]. fT was calculated using the formula fT = T × 0.01 × (3.66 -1.38 × log 10 SHBG (nmol/l)) [24].…”

Circulating steroid hormones in prostate carcinogenesis. Part 1 – Androgens

“…Three decades ago, it was shown that the mean serum T level was significantly higher in patients with a good response to PCa endocrine therapy than in those with a poor response (82), and PCa patients with metastases and high plasma T levels had significantly longer survival than those with low plasma T (83).…”