Presentation on theme: "Introduction The incidence of prostate cancer in Asians is lower compared to the Westerners in men with PSA <20 ng/ml. These differences could be due to."— Presentation transcript:
Introduction The incidence of prostate cancer in Asians is lower compared to the Westerners in men with PSA <20 ng/ml. These differences could be due to genetic influences or differences in the interaction of various hormones. Scientific evidence for the correlation between hormones, in particular androgens and the risk of prostate cancer have been equivocal. Animal model studies have shown that androgens and oestrogens play a part in mediating tumorigenesis. However, epidemiological studies based on serum samples from healthy and prostate cancer men have failed to demonstrate any clear relationship. Conclusions Serum levels of testosterone, DHT, cortisol and oestradiol may be associated with the development of prostate cancer. These hormones could be used to discriminate prostate cancer from benign causes, especially in Asian men with raised PSA. Results There were no significant difference in PSA levels between BPH (mean PSA= 12.96 ng/ml) and prostate cancer (mean PSA= 12.16 ng/ml) samples (p= 0.87). The serum hormone levels between CaP and BPH were not statistically significant for androstenedione, DHEA, FSH and LH. The following hormones did show statistically significant levels (α = 0.20), in descending order :- testosterone (p=0.03); DHT (p=0.14); cortisol (p=0.14); oestrodiol (p=0.20). Logistic regression and the likelihood of prostate cancer using these parameters and PSA gave a Nagelkerke R2=0.5 Previous study have reported increasing risk of prostate cancer with increasing testosterone, decreasing sex hormone-binding globulin (SHBG), and a nonlinear, inverse association with increasing eostradiol levels. Our study showed higher cortisol levels but lower testosterone, oestradiol, DHT levels in prostate cancer patients than in BPH patients. The independent variables in our logistic regression further suggest that these variables may be important in the development of prostate cancer. Methods Sera from 2 groups of patients were collected:- treatment naïve prostate cancer (CaP) patients (n=14) and benign prostatic hyperplasia (BPH) patients (n=14). The sera were then analysed using enzyme linked immunosorbent assay ( ELISA) for testosterone, oestradiol, androstenedione, cortisol, dihydrotestosterone (DHT), dehydroepiandesterone(DHEA), follicle stimulating hormone ( FSH), luteinizing hormone (LH) and prostate specific antigen (PSA). Aim A pilot prospective case-control study to analyse the correlation between hormonal levels and prostatic diseases in Asian males. References 1. Gann PH, Hennekens CH, Ma J, et al: Prospective study of sex hormone levels and risk of prostate cancer. J Natl Cancer Inst 88: 1118–1126, 1996. Poster presentation sponsor No. 020 Analysis on the influence of hormones in Malaysian patients with prostatic diseases Keng Lim Ng1, Sivaprakasam Sivalingam 1, Thiha Htun1, Azad Hassan Razack1, Norman Dublin2. 1 Division of Urology, Department of Surgery, University Malaya. 2 KPJ Tawakkal Specialist Hospital, Kuala Lumpur, Malaysia. TestosteroneDHT Cortisol Oestradiol BPH cancer
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