2129 Urinary Pca3 and Tmprss2:erg Help Predict Biopsy Outcome Prior to Initial Prostate Biopsy Using a Risk Group Analysis

Abstract

INTRODUCTION AND OBJECTIVES: There has been no consensus on the prostatic tissue and blood androgen concentrations in men with different stages and pathological grades of prostate cancer. In this study, testosterone (T) and dihydrotestosterone (DHT) concentrations in blood and needle biopsy specimens of prostate were examined by newly developed ultra sensitive LC-MS/MS method.METHODS: We analyzed 196 men (mean age 70.6 years) diagnosed as prostate cancer from November 2005 to July 2007. Those patients received systematic needle biopsy, and additionally one needle biopsy from proximal zone was conducted for the purpose of simultaneous determination of T and DHT. T and DHT concentrations in prostate tissues and blood were determined by LC-MS/MS method. Determination limit of this method was 0.5 pg/shot for T and 1 pg/shot for DHT. Concentration of T and DHT were expressed in pg/mg. T and DHT levels in tissue and blood were compared with Gleason score, clinical stage, and percentage of positive biopsy cores (% positive cores) by multivariate analyses.RESULTS: Median value of PSA and prostate volume measured by ultrasound were 11.5 ng/mL and 27.7 cc, respectively. Median values of T and DHT in blood were 3551.0 pg/mL and 330.5 pg/mL, respectively. There was a strong correlation between serum T and DHT. Median values of T and DHT in tissue were 0.566 pg/mg and 7.062 pg/mg, respectively. In multivariate analysis, serum PSA and tissue T levels were significantly associated with poor prognosis factors in men with prostate cancer. High testosterone levels in prostate tissue were related to high Gleason score (pϭ0.041), advanced clinical stage (pϭ0.002), and high proportion of % positive cores (pϭ0.001).CONCLUSIONS: Testosterone and dihydrotestosterone concentrations in blood or prostate tissue of needle biopsy were simultaneously examined by newly developed ultra sensitive quantifying method, LC-MS/MS. We confirmed that high testosterone levels in prostate tissue were related to high Gleason score, advanced clinical stage, and high proportion of % positive cores. These results suggest that testosterone level of needle biopsy specimens may be useful as a predictive factor in prostate cancer patients.