The risk of
cancer of the cervix is linked with sexual behavior. Although infectious agents, such as human papillomaviruses (HPVs) are implicated, these alone may be insufficient to induce the disease. We investigated the potential role of
estrogen,
androgen, and
polyamine metabolism as co-factors in the development of
cervical cancer. We obtained urine samples from patients with benign cervical disease (n=18) and
cervical cancer (n=18) and from age-matched normal female subjects (n=25). For 11
polyamine determination, an improved and sensitive gas-chromatographic with
nitrogen/
phosphorus-detection (GC/
NPD) procedure was used. The urinary levels of 25
androgens and
corticoids and 16
estrogens were quantitatively determined by gas chromatography-mass spectrometry-selected ion-monitoring (GC/MS/SIM). In the patients with
cervical cancer, the ratio of 16alpha-hydroxy
estrone (16alpha-
OH E1)/2-hydroxy
estrone (2-OH E1),
putrescine (Put)/N(1)-acetylspermidine (N(1)-acSpd) and 5beta-tetrahydrocortisol (THF)/5alpha-
tetrahydrocortisol (5alpha-THF) were significantly increased in comparison to the values of the normal controls. These data suggest: (1) an increase of 16alpha-hydroxylation in
estrogen metabolism; (2) the high activity of
polyamine oxidase (PAO) in
polyamine metabolism; and (3) the low activity of 5alpha-reductase in
androgen metabolism may play a significant role in the development of
cervical cancer. Although additional research is necessary, the combination of 16alpha-OH E1/2-
OH E1 and THF/5alpha-THF may provide a dual marker for the discrimination of benign cervical disease and
cervical cancer.