Insulin-like factor 3, luteinizing hormone and testosterone in testicular cancer patients: effects of β-hCG and cancer treatment.

Autor: Steggink LC; Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., van Beek AP; Division of Endocrinology, Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., Boer H; Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., Meijer C; Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., Lubberts S; Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., Oosting SF; Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., de Jong IJ; Department of Urology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., van Ginkel RJ; Division of Surgical Oncology, Department of Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., Lefrandt JD; Division of Vascular Medicine, Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., Gietema JA; Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., Nuver J; Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Jazyk: angličtina
Zdroj: Andrology [Andrology] 2019 Jul; Vol. 7 (4), pp. 441-448. Date of Electronic Publication: 2019 Jan 04.
DOI: 10.1111/andr.12581
Abstrakt: Background: Primary hypogonadism (low testosterone and high luteinizing hormone, LH) is present in approximately 20% of testicular cancer (TC) survivors after orchidectomy with or without chemotherapy.
Objectives: We investigated insulin-like factor 3 (INSL3), a novel marker of Leydig cell function, in TC patients.
Materials and Methods: We analyzed: (I) a cross-sectional cohort of TC patients after orchidectomy with or without chemotherapy (1988-1999) at long-term follow-up (median 36 and 35 years of age at follow-up, respectively) and healthy men of similar age; (II) a longitudinal cohort of chemotherapy-treated TC patients (2000-2008), analyzed before and 1 year after chemotherapy (median 29 years of age at chemotherapy). INSL3, testosterone, and LH were compared between groups and over time and related to pre-chemotherapy β-hCG levels.
Results: In the cross-sectional cohort, TC patients at median 7 years after orchidectomy and chemotherapy (n = 79) had higher LH (p < 0.001), lower testosterone (p = 0.001), but similar INSL3 as controls (n = 40). After orchidectomy only (n = 25), higher LH (p = 0.02), but no differences in testosterone or INSL3 were observed compared to controls. In the longitudinal cohort, patients with normal pre-chemotherapy β-hCG (≤5 mU/L, n = 35) had increased LH 1 year after chemotherapy compared to pre-chemotherapy (p = 0.001), and no change in testosterone or INSL3. In contrast, patients with high β-hCG pre-chemotherapy (n = 42) had suppressed LH, markedly elevated testosterone, and low INSL3 at start of chemotherapy, with increased LH, decreased testosterone, and increased INSL3 1 year later (all p < 0.001).
Discussion: Changes in LH show that gonadal endocrine function is disturbed before chemotherapy, 1 year later, and at long-term follow-up in chemotherapy-treated TC patients.
Conclusion: Pre-chemotherapy, β-hCG-producing tumors affect the gonadal endocrine axis, demonstrated by increased testosterone and decreased LH. INSL3 did not uniformly follow the pattern of testosterone.
(© 2019 American Society of Andrology and European Academy of Andrology.)
Databáze: MEDLINE
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