Serum testosterone, dihydrotestosterone, luteinizing hormone and follicle-stimulating hormone versus prostate specific antigen in patients with localized prostate adenocarcinoma who underwent radical prostatectomy. Radioimmunoassays measurements

The relation of steroid hormones (SH) with carcinogenesis is not well understood. There is a variation of opinions among researchers about the prognostic value of serum SH in patients with localized prostate cancer (PC). The aim of this was to study serum SH in patients with localized PC before and after radical prostatectomy (RP). Seventy patients with mean age 67+/-8 years, were studied. The diagnosis was confirmed by histology after a biopsy. None of the patients was submitted to hormonal treatment or radiotherapy prior to RP. Serum testosterone (TST), dihydrotestosterone (DHT), luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels were examined prior RP and one year following RP, by radioimmuno assay (RIA) or immunoradiometric assay (IRMA) methods. Based on serum PSA levels before and one year after RP, 66 of the patients did not have biochemical recurrence while 4 patients developed biochemical recurrence due to residual disease and were treated with flutamide and a LH-RH analogue. In the group of 66 patients there was a statistically significant increase in serum TST (P<0.001), LH (P=0.004) and FSH (P<0.001), and statistically significant decrease in serum DHT (P<0.001). In the four patients with biochemical recurrence, TST increased and serum DHT, LH and FSH decreased. In this group the reduction of DHT and LH, FSH were due to treatment with flutamide and a LH-RH analogue respectively. Our findings suggest that after RP increase of serum LH and FSH may have caused an increase in serum TSH and a decrease of serum DHT. If those changes are due to the hypothalamic-pituitary axis it may be that the prostate neoplasm before RP may have secreted a substance that induced a negative feedback to the pituitary gonadotrophin secretion, which was unrelated to varying serum PSA levels.