The Relationship Between PSA and Total Testosterone Levels in Men With Prostate Cancer

被引：10

作者：

Flores, Jose M. ^{[1
]}

Bernie, Helen L. ^{[1
]}

Miranda, Eduardo ^{[1
]}

Nascimento, Bruno ^{[1
]}

Schofield, Elizabeth ^{[2
]}

Benfante, Nicole ^{[1
]}

Carlsson, Sigrid ^{[3
,4
]}

Mulhall, John P. ^{[1
]}

机构：

[1] Mem Sloan Kettering Canc Ctr, Urol Serv, Sexual & Reprod Med Program, 16 E 60th St, New York, NY 10065 USA

[2] Mem Sloan Kettering Canc Ctr, Dept Psychiat & Behav Sci, New York, NY 10065 USA

[3] Mem Sloan Kettering Canc Ctr, Dept Surg, Urol Serv, New York, NY 10065 USA

[4] Mem Sloan Kettering Canc Ctr, Dept Epidemiol & Biostat, New York, NY 10065 USA

来源：

JOURNAL OF SEXUAL MEDICINE | 2022年 / 19卷 / 03期

基金：

美国国家卫生研究院;

关键词：

Testosterone; PSA; Prostate Cancer; Testosterone De fi ciency; Hypogonadism; SERUM TESTOSTERONE; GLEASON SCORE; OLDER MEN; ANTIGEN; THERAPY; RISK; AGE; GRADE; HYPOGONADISM; ASSOCIATION;

D O I：

10.1016/j.jsxm.2022.01.003

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Prostate-specific antigen (PSA) secretion is a testosterone (T) dependent process. Published data suggest that a low T level is an independent predictor of higher-grade prostate cancer (PC). Aim: To evaluate the relationship between T and PSA in patients with PC. Methods: All men diagnosed with PC with a recorded pre-treatment total T level measurement were included in this analysis. We analyzed demographic, clinical, and pathological data. Patients were stratified according to pretreatment PSA levels: <2 ng/mL, 2-4 ng/mL, >4 ng/mL. Low T was defined as total T < 10.4 nmol/L (300 ng/dL), very low T < 6.9 nmol/L (200 ng/dL). Outcomes: T levels by PSA groups according to the PC pathology. Results: In this retrospective study, mean patient age was 61 years among 646 men. The distribution by PSA group was: 8% (<2), 17% (2-4), and 76% (>4). The mean T level across the entire cohort was 13 nmol/L (374 ng/dL). Overall, 30% had a T level < 10.4 nmol/L (300 ng/dL). The mean total T level by PSA group was: <2 ng/mL, 7 nmol/L (206 ng/dL); 2-4 ng/mL, 13 nmol/L (362 ng/dL); >4 ng/mL, 14 nmol/L (393 ng/dL), P <.001. PSA <4 ng/mL was a significant predictor of low T in men with PC GS >= 8. PSA <2 ng/mL was a significant predictor of very low T independent of the PC pathology. Clinical Implications: These findings suggest that clinicians should consider measuring T levels when a patient diagnosed with PC GS =8 and PSA level <4 ng/mL, and for each patient with PSA level <2 ng/mL independent of the PC pathology. Strengths & Limitations: Our study has several strengths including (i) inclusion of a large population of men, (ii) use of a database which is audited and reviewed for accuracy annually, and (iii) use of an accurate T assay (LCMS). Nonetheless, there are limitations: (i) the subjects of the study are from a single institution, and (ii) we did not measure free T levels. Conclusion: In men with PC with GS >= 8, PSA level <4 ng/mL predicts low T. PSA <2 ng/mL predicts very low T independent of the PC pathology. Copyright (C)22, International Society of Sexual Medicine. Published by Elsevier Inc. All rights reserved.

引用

页码：471 / 478

页数：8

共 43 条

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