Follicle-Stimulating Hormone and the Pituitary-Testicular-Prostate Axis at the Time of Initial Diagnosis of Prostate Cancer and Subsequent Cluster Selection of the Patient Population Undergoing Standard Radical Prostatectomy

Autor: Claudio Cocco, Teodoro Sava, Claudio Ghimenton, Mario Romano, Antonio Benito Porcaro, Aldo Petrozziello, Emanuele Rubilotta, Beatrice Caruso, Vincenzo Lacola, Luigi Comunale, Filippo Migliorini, Stefano Zecchinini Antoniolli, Carmelo Monaco
Rok vydání: 2012
Předmět:
Male
medicine.medical_treatment
Follicle-stimulating hormone
Luteinizing hormone
Total testosterone
Free testosterone
Estradiol hormone
Prostate-specific antigen
Prostate cancer
Prostate
Testis
Cluster Analysis
Testosterone
Estradiol
Prostatectomy
Middle Aged
medicine.anatomical_structure
Pituitary Gland
Follicle Stimulating Hormone
Human
Kallikreins
hormones
hormone substitutes
and hormone antagonists
Image-Guided Biopsy
endocrine system
medicine.medical_specialty
Urology
Decision Support Techniques
Predictive Value of Tests
Internal medicine
medicine
Humans
Aged
Retrospective Studies
Analysis of Variance
business.industry
Patient Selection
Prostatic Neoplasms
Luteinizing Hormone
Prostate-Specific Antigen
medicine.disease
Prolactin
Endocrinology
Linear Models
Neoplasm Grading
business
Hormone
Zdroj: Urologia Internationalis. 90:45-55
ISSN: 1423-0399
0042-1138
Popis: Aim: A preceding exploratory analysis has shown that follicle-stimulating hormone (FSH) was significantly correlated to and predicted by prostate-specific antigen (PSA) in a prostate cancer population. The aim of the study was to evaluate FSH physiopathology along the pituitary-testicular-prostate (PTP) axis at the time of initial diagnosis of prostate cancer in an operated population clustered according to the FSH/PSA ratio. Patients and Methods: The study included 93 patients who underwent standard radical prostatectomy. Age, percentages of positive cores at transrectal ultrasound scan biopsy (TRUSB) (P+), biopsy Gleason score (bGS), pathology Gleason score (pGS), luteinizing hormone (LH), FSH, prolactin hormone (PRL), total testosterone (TT), free testosterone (FT), estradiol (ESR) and PSA were the continuous variables. Category variables were pT and biopsy/pathology Gleason pattern I/II (b/pGPI/II). The population was clustered according to the FSH/PSA ratio which was computed from empirical data and then ranked for clustering the population as groups A (range 0.13 ≤ FSH/PSA ≤ 0.20), B (range 0.20 < FSH/PSA ≤ 0.50), C (range 0.50 < FSH/PSA ≤ 0.75), D (range 0.75 < FSH/PSA ≤ 1.00), E (range 1.00 < FSH/PSA ≤ 1.25), F (range 1.25 < FSH/PSA ≤ 2.00), G (range 2.00 < FSH/PSA ≤ 2.25), H (range 2.25 < FSH/PSA ≤ 6.40) and I (range 6.40 < FSH/ PSA ≤ 19.40). The model was assessed by simple linear regression analysis and differences between the groups were investigated by analysis of variance (ANOVA) for continuous variables and by contingency tables for category variables. Results: FSH was significantly correlated to and predicted by PSA in groups A (p = 0.04), B (p < 0.0001), C (p < 0.0001), D (p < 0.0001), E (p < 0.0001), F (p < 0.0001), G (p < 0.0001), H (p = 0.0001) and I (p = 0.001). Also, clusters (A–I) differed significantly for mean values of FSH (p < 0.0001), LH (p < 0.0001), TT (p = 0.04), PSA (p < 0.0001), bGS (p = 0.005), pGS (p = 0.01) and PSA/FT ratio (p < 0.0001); moreover, the nine groups showed significant different frequency distributions of pGPI (p = 0.02), pGPII (p = 0.0002) and bGPI (p = 0.04). Conclusion: The ranking FSH/PSA ratio significantly clustered, along the PTP axis, an operated population diagnosed with prostate cancer. Also, the ranking FSH/PSA ratio selected prostate cancer clusters expressing different levels of hormonal disorder along the PTP axis and prognostic potential with different risks of progression. As a theory, in the current advancing world, the ranking FSH/PSA model might be considered as an interesting and effective tool for prostate cancer study as well as individualized, risk-adapted approaches of the disease. However, confirmatory studies are needed.
Databáze: OpenAIRE
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