Endocrine patterns in patients with benign and malignant prostatic diseases

BACKGROUND. The known importance of the endocrine system, particularly of s teroid hormones, for development of the prostate gland and the fact that st eroid hormones act as immunmodulators prompted us to compare hypophyseal, a drenal, and gonadal hormones, including cortisol, in patients with benign a nd malignant prostatic diseases. METHODS. Patients with newly diagnosed, untreated prostate cancer (PC) (n = 75) and, as a control population, those with untreated lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) (n = 159) entere d this prospective study. In all patients, the following parameters were ob tained by serum analysis: prostate-specific antigen (PSA), human luteinizin g hormone (hLH), human follicle-stimulating hormone (hFSH), testosterone, e stradiol (E2), cortisol, and dehydroepiandrosterone-sulphate (DHEA-S). Seru m samples were collected of fasting patients between 7.30-10.00 AM, RESULTS. Age was comparable in both groups (PC: 65.6 +/- 7.6 years (mean +/ - standard deviation) vs, controls: 64.9 +/- 8.1 years; P = 0.56). HFSH (PC : 6.6 +/- 3.9 mIU/ml; controls: 8.4 +/- 6.4 mIU/ml; P = 0.04), hLH (PC: 5.3 +/- 4.8mIU/ml; controls: 7.6 +/- 6.2 mIU/ml; P = 0.009), and estradiol (PC : 25.8 +/- 12.7 pg/ml; controls: 32.6 +/- 12.6 pg/ml; P = 0.0003) were sign ificantly lower in PC patients than controls. Cortisol (PC: 16.7 +/- 4.2 mu g/dl; controls: 13.5 +/- 4.3 mu g/dl; P < 0.0001) was significantly higher in cases. The difference for cortisol and estradiol concentrations between PC patients and controls held true in all life-decades. Serum concentratio ns for DHEA-S and testosterone were comparable between PC and control patie nts. In PC patients, none of the endocrine parameters correlated to serum P SA or clinical/patohological stage. CONCLUSIONS. Patients with newly diagnosed, untreated PC yielded significan tly higher cortisol and lower estradiol serum concentrations than controls. The known effect of cortisol on the immune status warrants further studies . (C) 2000 Wiley-Liss, Inc.