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Korean J Urol Oncol > Volume 12(1); 2014 > Article
The Korean Journal of Urological Oncology 2014;12(1): 29-37.
Sex Hormone-Binding Globulin Concentration in Patients with Prostate Cancer Treated with Radical Prostatectomy
Myungsun Shim 1, Cheryn Song 1, Jintaek Park 1, Minkyu Kang 1, Moo-Song Lee 2, Jongwon Kim 3, Hanjong Ahn 1
Departments of 1Urology and 2Clinical Epidemiology & Biostatistics, University of Ulsan College of Medicine, Asan Medical Center, 3Department of Urology, Korea Cancer Center Hospital, Seoul, Korea
Published online: April 30, 2014.
ABSTRACT
Purpose:
We aimed to identify the relationship between the serum testosterone (TS) axis and the clinically localized prostate cancer and to evaluate the changes in hormone concentrations after radical prostatectomy (RP).
Materials and Methods:
Blood samples were drawn from 699 patients with prostate cancer before and after RP, without hormone or radiation therapy, and from 700 age-matched healthy men between 7:00 and 9:00 A.M., and their serum concentrations of total TS and sex hormone-binding globulin (SHBG) were measured.
Results:
Patients with prostate cancer had lower mean SHBG (55.8±22.0 vs. 61.4±24.2 nmol/L) and higher mean free TS (FT) (7.1±2.5 vs. 6.3±2.6 ng/dl), bioavailable TS (BAT) (158.2±55.2 vs. 138.1±56.5 ng/dl), and free TS index (FTI) (31.3±12.0 vs. 27.1±11.6) than healthy controls (all, p<0.001), while total TS did not differ. Following RP, patients with prostate cancer showed significant increases in SHBG (65.6±26.3 vs. 56.3±21.6 nmol/L) and subsequent decreases in FT (6.4±4.4 vs. 7.2±2.5 ng/dl), BAT (138.2±50.3 vs. 158.7±55.3 ng/dl), and FTI (26.5±11.1 vs. 31.2±11.7) (all, p<0.001), whereas total TS remained unchanged. Preoperative SHBG concentration was significantly lower in patients with pathologic Gleason score (GS) <7 than in those with GS ≥7 (p<0.001). SHBG was an independent predictor of pathologic GS <7 (p=0.003), along with preoperative prostatic specific antigen (PSA) concentration and biopsy GS.
Conclusions:
Prostate cancer influences the sex hormonal axis, modulating SHBG concentration and increasing the utilization of bioactive TS. (Korean J Urol Oncol 2014;12:29-37)
Key Words: Prostate cancer; Testosterone; Sex hormone-binding globulin; Prostatectomy
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