唾液游离睾酮测定的临床应用

借鉴国内外文献报告的方法，建立了唾液游离睾酮的测定方法，可替代血游离睾酮的测定。本法批内变异系数５．７５％，批间变异系数８．４５％，提取回收率９４％，最小检出量（灵敏度）１２．３０ｐｇ（９５％可信限）。唾液游离睾酮与血清总睾酮之间有极好的相关性（ｒ＝０．９８４，Ｐ＜０．００１）。唾液游离睾酮测定方法实用、可靠，在临床应用中取得满意结果，加之取材容易，病人易于接受，具有很好的社会和经济效益。     

唾液游离睾酮测定的临床应用

借鉴国同外文献报告的方法，建立了唾液游离睾酮的测定方法，可替代血游离睾酮的测定。本法批内变异系数５．７５％，批间变异系数８．４５％，提取回收纺９４％，最小检出量１２．３０ｐｇ。唾液游离睾酮与血清总睾酮之间有极好的相关性。     

前列腺组织阶段性增长的特性研究——1 306例定量分析

为了探讨前列腺的自然增长过程，应用超声定量学研究方法对１３０６例年龄从新生儿至９２岁的前列腺进行了测定。结果表明，前列腺具有随年龄增长而呈阶段性增长的规律，即０～９岁青春期前缓慢增长期，每年增长０．１４ｇ；１０～３０岁的快速增长期，每年增长０．８４ｇ；３０～５０岁的再缓慢增长期，每年增长０．２１ｇ；５０～９０岁的再快速增长期含两种情况，一部分人以每年增长０．５０ｇ，而另一部分人则以每年１．２０ｇ的速度增长，从而导致了临床上的前列腺增生症（ＢＰＨ），这个规律符合＾Ｙ＝１９．３６＋１．３６Ｘ′－０．５８Ｘ′２＋０．３３Ｘ′３的方程。本研究建立了不同年龄组的前列腺体积正常参考值，并论证了前列腺随年龄的阶段性增长及其特征。     

不同前列腺组织中睾酮及双氢睾酮含量测定的研究

目的　研究雄激素在前列腺增生症及前列腺癌发生中的作用。　方法　分别测定正常人、前列腺增生症患者以及前列腺癌患者血清和前列腺组织中睾酮 (T)及双氢睾酮 (DHT)的浓度。　结果　表明随着年龄增长 ,正常人血清中T水平逐渐下降而DHT浓度保持相对稳定。前列腺增生症或前列腺癌患者血清中两种雄激素浓度与正常对照组相比差异无显著性意义 (P >0 0 5 )。长期服用非那雄胺治疗的前列腺增生症患者血清中的DHT水平明显降低而T水平基本不变。各种组织中DHT的含量均为T的几十倍以上 ,前列腺增生症及前列腺癌组织中DHT的含量明显高于正常组织 (P<0 0 1) ,而各组之间组织中睾酮含量差异无显著性意义 (P >0 0 5 )。长期应用非那雄胺治疗前列腺增生患者组织中DHT的含量没有明显降低 ,而且不同部位增生组织中DHT的含量差异有显著性意义。　结论　前列腺增生症及前列腺癌组织中DHT的高浓度积聚与其发病密切相关 ,组织中DHT的积聚可能是由于前列腺局部 5a 还原酶增高所致 ,而且前列腺组织中可能存在着不止一种 5a 还原酶的作用。     

正常男性唾液睾酮含量与年龄的关系研究

本文应用碘标放射免疫法检测了339例正常男性唾液睾酮浓度,探讨了唾液睾酮与年龄的关系,并就唾液睾酮的临床应用进行了讨论,提出了不同年龄阶段唾液睾酮的正常值:3～8岁唾液睾酮浓度均值为3.1pg/ml;9岁,4.5pg/ml;10～12岁,24.6pg/ml;13岁,41.7pg/ml;14～16岁,60.3pg/ml;17岁,86.9pg/ml;18～55岁,114.1pg/ml;51～55岁,88pg/ml;56～78岁,70.7pg/ml。     

男性少年唾液附睾酮水平与青春期发育的关系

为了解男性少年青春期发育情况,在1990年对北京市海淀区一所普通中学的初一初二两个年级157名12～15岁健康男生进行了调查研究,内容包括某些形态发育及性发育指标的测量,唾液睾酮水平的氚标放免测定,结果表明男性少年唾液睾酮水平有随年龄增长及阴毛发育分期的增长而增长的趋势。唾液睾酮还与其他性发育指标以及形态发育指标有一定程度的相关性。     

前列腺组织中睾酮含量状态与前列腺生理和增生的关系

目的：检测前列腺组织中总睾酮、结合睾酮和游离睾酮的含量，并分析其与前列腺生理和组织增生的关系。方法：14例相对年轻正常前列腺组织、22例良性前列腺增生(BPH)组织和ll例相应年龄段前列腺对照组织，制备组织脑浆和胞核提取液，乙醚萃取分离游离和结合睾酮，采用^125I标记睾酮放免试剂盒测定睾酮的含量。结果：前列腺组织中睾酮存在结合和游离2种状态，结合态为多，约占2/3；3组比较，总睾酮、游离和结合睾酮含量无显著差异。结论：前列腺组织中睾酮存在游离和结合二种状态，共同维持局部高水平的总睾酮含量，并且随年龄增长而保持稳定，有利于睾酮在前列腺生理和组织增生过程中的作用。     

输精管结扎干扰前列腺增生过程的机制探讨——精浆睾酮双氢睾酮的放射免疫测定

本文应用放射免疫测定的方法检测了13例输精管结扎后(平均15.3年,平均年龄50岁)的男性精浆双氢睾酮和睾酮的浓度,另取同年龄组男性13例作为对照。结果表明,精浆睾酮在结扎组(374.54p/ml)和正常对照组(315.64Pg/ml)中没有明显差异,而结扎组精浆中双氢睾酮(46.21pg/ml)却明显低子对照组(184.27pg/ml(p<0.01)。作者认为,输精管结扎对精浆DHT有长期影响,这可能是其对前列腺增生过程产生抑制作用的原因之一。     

青年睾丸、附睾、前列腺、肾上腺组织中血清睾酮含量的测定

本文应用放射免疫技术 ,测定一组青年睾丸、附睾、前列腺、肾上腺组织中的睾酮含量 ,为临床研究提供参考数据。材料和方法一、实验材料1996年 8月～ 1996年 10月 ,上海市意外死亡青年男性捐献者的新鲜睾丸、附睾、前列腺、肾上腺共 19例。年龄最小 19岁 ,最大 37岁 ,平均 2 6 .37± 4 .2 2岁。二、实验试剂和器材1.ＰＢＳ缓冲液 ,ｐＨ 7.2 (由长征医院制剂室配制 )2 .血清睾酮放射免疫测定试剂盒 (中美合资天津九鼎医学生物工程有限公司生产 )3.电动玻璃匀浆机ＤＹ89 Ⅰ型 (宁波新芝科器研究所生产 )4.离心沉淀机ＬＸＪ Ⅱ型 (上海医用分析…     

Changes in male salivary testosterone concentration with age

Using a specific and sensitive radioimmunoassay for testosterone, the concentration of the steroid has been determined in samples of saliva taken from men of various ages. The results clearly show that the mean salivary testosterone concentration, which related to the plasma-free, non-protein-bound steroid concentration, falls with advancing age from 236 pmol/l in the 3rd decade to 100 pmol/l in the 8th decade.     

睾酮与前列腺癌研究进展

通过去雄激素治疗能够有效地抑制前列腺癌的进展,但越来越多的证据对睾酮与前列腺癌关系的传统观点提出挑战。高水平睾酮并非前列腺癌的危险因子,也不促进前列腺癌的发展;反而低水平睾酮意味着更差的病理分期。目前为止并没有强有力的证据证明睾酮促使前列腺癌的发生发展。睾酮与前列腺癌的关系相当复杂,值得进一步研究探索。     

The relationship between pre-radiation therapy testosterone levels and prostate cancer aggressiveness

We investigated whether there is an association between testosterone levels and prostate cancer aggressiveness in patients treated with radiation therapy who underwent a prostatectomy or prostate radiotherapy (EBRT). A total of 380 patients who received primary or post-operative radiotherapy were identified. At the time of radiotherapy, baseline testosterone levels and body mass index (BMI) measurements were available. On multivariate analysis (MVA), higher prostate-specific antigen (PSA) levels were predictive of testosterone ≥10.4  (OR = 1.3, p = .04) and testosterone ≥12.0 nmol/L (OR = 1.3, p = .04). Patients with a Gleason score ≥8 were more likely to have testosterone <8 nmol/L than patients with a lower score (31% vs. 20%, p = .043). On univariate analysis, a Gleason score ≥8 was associated with a lower likelihood of having a normal (≥8 nmol/L) testosterone level (OR = 0.51, 95% CI: 0.3–0.9, p = .02), and on MVA adjusted for post-surgical versus primary EBRT and BMI (≥30 kg/m²), the Gleason score lost its statistical significance (p = .09). While higher PSA levels are associated with higher testosterone levels, the interaction between Gleason score and testosterone is unclear and merits further study.     

The relationship between total and free serum testosterone and the risk of prostate cancer and tumour aggressiveness

OBJECTIVE

To analyse the relationship between the levels of total and free serum testosterone and the risk of prostate cancer and tumour aggressiveness.

PATIENTS AND METHODS

Total and free serum testosterone were determined in 478 patients consecutively assessed by transrectal ultrasonography‐guided prostate biopsy because of an abnormal digital rectal examination and/or serum prostate‐specific antigen (PSA) level of >4.0 ng/mL. Tumour aggressiveness was assessed according to serum PSA level, biopsy Gleason score and clinical stage in the subset of 216 patients with cancer (45.2%). We also compared prostate cancer risk and tumour aggressiveness in 80 hypogonadal patients (16.7%) and 398 eugonadal patients (83.3%).

RESULTS

The median total serum testosterone level in patients without and with prostate cancer was 466.0 and 466.5 ng/dL, respectively (P > 0.05); the median levels of free serum testosterone were 9.9 and 10.0 pg/mL, respectively (P > 0.05). The cancer detection rate in hypogonadal patients was 41.3% (33/80) and 46.0% in eugonadal patients (183/398) (P > 0.05). The median level of total testosterone was 433 ng/dL in patients with low‐risk prostate cancer, 467 ng/dL in those with intermediate‐risk tumours and 468 ng/dL in those with high‐risk tumours (P > 0.05); the median levels of free testosterone were 9.4, 9.8 and 10.3 pg/mL, respectively (P > 0.05).

CONCLUSIONS

Prostate cancer risk and tumour aggressiveness are not related to serum levels of total and free testosterone, but hypogonadal patients do not have a greater risk of prostate cancer and tumour aggressiveness.     

The relationship of serum testosterone to erectile function in normal aging men

PURPOSE: We evaluated the variation in serum testosterone in normal aging men and its relationship with erectile function. MATERIALS AND METHODS: In a study that was not community based and during a free screening program for prostate cancer 1,071 men were invited to complete a sexual activity questionnaire, that is the abridged 5-item version of the International Index of Erectile Function (IIEF-5), as a diagnostic tool for erectile dysfunction. Possible scores on the IIEF-5 are 1 to 25 and erectile dysfunction was classified into 5 categories based on the scores, namely severe-1 to 7, moderate-8 to 11, mild to moderate-12 to 16, mild-17 to 21 and none-22 to 25. Serum total testosterone was measured between 8:00 and 10:00 a.m. in all men. RESULTS: Of the 1,071 men 965 (90.1%) were included in this study, of whom 88% were white and 12% were black. Mean age was 60.7 years. In this sample the prevalence of all degrees of erectile dysfunction was estimated to be 53.9%. The degree of erectile dysfunction was mild in 21.5% of cases, mild to moderate in 14.1%, moderate in 6.3% and severe in 11.9%. According to age the erectile dysfunction rate was 36.4% in the 40 to 49, 42.5% in the 50 to 59, 58.1% in the 60 to 69, 79.4% in the 70 to 79 and 100% in the 80 years and older groups (p <0.05). The variation in mean serum total testosterone in the age groups was not statistically significantly different (p >0.05). Pearson coefficients of age and total testosterone did not reveal any significant correlation (r = 0.00376, p = 0.907), similar to IIEF-5 score and total testosterone (r = 0.0163, p = 0.612). However, analysis of the variables IIEF-5 and age showed a statistically significant inverse or negative relationship (r = -0.3449, p <0.05). CONCLUSIONS: Erectile dysfunction showed a clear association with aging but no consistent correlation of total testosterone with erectile condition was identified.     

Comparative pharmacokinetics of testosterone enanthate and testosterone cyclohexanecarboxylate as assessed by serum and salivary testosterone levels in normal men

The pharmacokinetics of 2 testosterone esters, testosterone enanthate and testosterone cyclohexanecarboxylate, were compared in a single blind crossover study in healthy young men. Their effects on serum and salivary levels of testosterone, as well as on the serum levels of LH, FSH and prolactin were measured after the injection of doses equivalent to 140 mg free testosterone. Both preparations yielded supraphysiological testosterone levels in serum and saliva as early as 2 h following injection, reaching peak levels 4 to 5 times above basal between 8 and 24 h. LH and FSH levels were suppressed as long as serum testosterone levels were elevated. Nine days after injecting testosterone enanthate and 7 days after giving testosterone cyclohexanecarboxylate, serum and salivary levels of testosterone had returned to basal. The longer activity of testosterone enanthate was also evidenced from more extended suppression of gonadotrophin levels. Although neither preparation is ideal because of the initial supraphysiological peaks, testosterone enanthate appears preferable for clinical use because of its slightly longer duration of action.     

前列腺癌患者血清睾酮水平与前列腺穿刺活检阳性的相关性

目的探讨血清总睾酮水平与前列腺穿刺活检阳性之间的相关性,为临床个体化治疗方案的选择提供理论依据。方法 2015年9月至2019年3月期间在汉中市人民医院泌尿外科接受前列腺穿刺活检的患者,收集患者的年龄、血清总前列腺特异性抗原(tPSA)及性激素等相关资料,观察这些指标对前列腺穿刺活检阳性率的影响。结果在113例患者中,前列腺癌(PCa)患者检出率共89例,穿刺阳性率为78.76%。与穿刺阴性组比较,患者血清tPSA[(12.42±4.64)vs.(5.35±1.66)ng/mL,P<0.001]和催乳素水平[(8.55±2.48)vs.(6.91±1.92)ng/L,P=0.003]升高与前列腺穿刺活检阳性有关,而总睾酮激素水平下降与前列腺穿刺活检阳性有关[(12.64±3.28)vs.(16.85±3.37)nmol/L,P<0.001]。多变量分析证实tPSA[P<0.001,OR=3.383(1.924~5.342)]和血清睾酮[P=0.038,OR=1.361(1.124~1.927)]是预测前列腺穿刺活检阳性的独立预测因子。受试者工作曲线(ROC)显示tPSA水平与前列腺穿刺阳性风险呈正相关,曲线下面积(AUC)为0.989,最佳截断值为8.022,敏感度和特异度分别为87.5%和98.88%;总睾酮激素水平与前列腺穿刺阳性风险呈负相关,AUC为0.786,最佳截断值为17.85,敏感度和特异度分别为66.67%和78.65%,差异具有统计学意义(P<0.001)。结论低血清睾酮激素与前列腺穿刺检测PCa的风险有关,这些结果可能揭示了PCa与睾酮两者关系的潜在机制。     

Testosterone in human studies: Modest associations between plasma and salivary measurements

Testosterone is involved in many processes like aggression and mood disorders. As it may easily diffuse from blood into saliva, salivary testosterone is thought to reflect plasma free testosterone level. If so, it would provide a welcome noninvasive and less stressful alternative to blood sampling. Past research did not reveal consensus regarding the strength of the association, but sample sizes were small. This study aimed to analyse the association in a large cohort. In total, 2,048 participants (age range 18–65 years; 696 males and 1,352 females) were included and saliva (using cotton Salivettes) and plasma were collected for testosterone measurements. Levels were determined by enzyme‐linked immunosorbent assay and radioimmunoassay respectively. Free testosterone was calculated by the Vermeulen algorithm. Associations were determined using linear regression analyses. Plasma total and free testosterone showed a significant association with salivary testosterone in men (adjusted β = .09, p = .01; and β = .15, p < .001, respectively) and in women (adjusted β = .08, p = .004; and crude β = .09, p = .002 respectively). The modest associations indicate that there are many influencing factors of both technical and biological origin.     

Proliferative responses of cultured rat prostate and human benign prostatic hyperplasia

The proliferative responses of rat prostate and human benign prostatic hyperplasia have been followed in organ culture using [125I] iododeoxyuridine uptake to monitor DNA synthesis. In serum-free cultures, testosterone induced a marked increase in DNA synthesis (three-fold) in 4- to 6-month-old rat prostates at concentrations of 4 x 10(-9) to 4 x 10(-6) M, whereas in greater than 12-month-old rat prostates the response was less marked. Human benign prostatic hyperplasia also showed an increased uptake at similar testosterone concentrations and of a similar magnitude to the response of greater than 12-month-old rat prostates. At 10(-5) M DNA synthesis was markedly suppressed in cultures of both rat and human prostate. The proliferative response of human benign prostatic hyperplasia increases up to days 3 to 4 in culture and then declines in both control and hormone-treated groups and may represent repair processes which appear to be hormone dependent.