促肾上腺皮质激素参与接受雄激素剥夺治疗局限性前列腺癌男性雄激素合成的调节。

Adrenocorticotropic hormone is involved in regulation of androgen synthesis in men receiving androgen deprivation therapy for localized prostate cancer.

机构信息

Division of Urology, Department of Regenerative and Transplant Medicine, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.

出版信息

J Urol. 2010 Nov;184(5):1971-6. doi: 10.1016/j.juro.2010.06.115.

DOI:10.1016/j.juro.2010.06.115

PMID:20884032

Abstract

PURPOSE

We elucidated the regulatory mechanism of adrenal androgen synthesis and examined the influence of pituitary-adrenal axis activity on prostate specific antigen during androgen deprivation therapy.

MATERIALS AND METHODS

A total of 72 patients with localized prostate cancer were prospectively studied based on blood samples before and after androgen deprivation therapy for 6 months. Serum pituitary hormones, androgens and prostate specific antigen were measured using highly sensitive assays.

RESULTS

After androgen deprivation therapy serum levels of luteinizing hormone, follicle-stimulating hormone, testosterone, dehydroepiandrosterone sulfate, androstenedione and prostate specific antigen decreased compared with those at the baseline (all values p <0.001). No difference was noted between serum levels before and after androgen deprivation therapy in growth hormone (p = 0.098) and adrenocorticotropic hormone (p = 0.101). Each serum level of luteinizing hormone, follicle-stimulating hormone and growth hormone after androgen deprivation therapy was not correlated with the serum levels of androgens or prostate specific antigen. The serum adrenocorticotropic hormone level after androgen deprivation therapy was correlated with the serum levels of testosterone (p = 0.002), dehydroepiandrosterone sulfate (p = 0.002), androstenedione (p = 0.006) and prostate specific antigen (p <0.001). Serum dehydroepiandrosterone sulfate and androstenedione levels were also correlated with serum prostate specific antigen (p <0.001 and p = 0.002, respectively).

CONCLUSIONS

In patients treated with androgen deprivation therapy the pituitary-adrenal axis mediated by adrenocorticotropic hormone has a central role in the regulation of androgen synthesis. Serum adrenocorticotropic hormone and adrenal androgen concentrations were correlated with the posttreatment prostate specific antigen. Adrenocorticotropic hormone mediated androgen synthesis is a potential target for advanced androgen deprivation therapy.

摘要

目的

阐明肾上腺雄激素合成的调控机制，并研究在雄激素剥夺治疗期间，垂体-肾上腺轴活性对前列腺特异抗原的影响。

材料与方法

共前瞻性研究了 72 例局限性前列腺癌患者，依据雄激素剥夺治疗前及治疗 6 个月后的血样。使用高度敏感的检测方法测定血清垂体激素、雄激素和前列腺特异抗原。

结果

雄激素剥夺治疗后，血清黄体生成素、卵泡刺激素、睾酮、硫酸脱氢表雄酮、雄烯二酮和前列腺特异抗原水平较基线时下降（所有 P 值均＜0.001）。治疗前后生长激素（P = 0.098）和促肾上腺皮质激素（P = 0.101）的血清水平无差异。雄激素剥夺治疗后，每个黄体生成素、卵泡刺激素和生长激素的血清水平与雄激素或前列腺特异抗原的血清水平均无关。雄激素剥夺治疗后血清促肾上腺皮质激素水平与血清睾酮（P = 0.002）、硫酸脱氢表雄酮（P = 0.002）、雄烯二酮（P = 0.006）和前列腺特异抗原（P＜0.001）水平相关。血清硫酸脱氢表雄酮和雄烯二酮水平与前列腺特异抗原也相关（P＜0.001 和 P = 0.002）。