Androgens are considered to play a substantial role in pathogenesis of both
benign prostatic hyperplasia (BPH) and
prostate cancer. The importance of determination of
androgen levels in tissue and serum for
cancer progression and prognosis has been poorly understood. The aim of study was to find out hormonal differences in both diseases, their correlations between intraprostatic and serum levels and predicted value of their investigation.
Testosterone,
dihydrotestosterone,
androstenedione and also
epitestosterone were determined in prostate tissue from 57 patients who underwent transvesical
prostatectomy for BPH and 121 patients after radical
prostatectomy for
prostate cancer. In 75 subjects with
cancer and 51 with BPH the serum samples were analyzed for
testosterone,
dihydrotestosterone and SHBG. Significantly higher intraprostatic
androgen concentrations, i.e. 8.85+/-6.77 versus 6.44+/-6.43 pmol/g, p<0.01 for
dihydrotestosterone, and 4.61+/-7.02 versus 3.44+/-4.53 pmol/g, p<0.05 for
testosterone, respectively, were found in patients with
prostate cancer than in BPH. Higher levels in
cancer tissue were found also for
epitestosterone. However, no differences were found in serum levels. Highly significant correlations occurred between all pairs of intraprostatic
androgens and also
epitestosterone as well as between serum
testosterone and
dihydrotestosterone (p<0.001) in both BPH and
cancer groups. Correlation was not found between corresponding tissue and serum
testosterone and
dihydrotestosterone, either in benign or
cancer samples. The results point to importance of intraprostatic
hormone levels for evaluation of
androgen status of patients, contrasting to a low value of serum
hormone measurement.