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Advanced prostate cancer is associated with a decrease in serum luteinizing hormone.

H Hilz1, M Graefen, J Noldus

  • 1Institut für Medizinische Biochemie und Molekularbiologie, Universitätskrankenhaus Eppendorf, Hamburg, Deutschland. hilz@uke.uni-hamburg.de

European Urology
|August 15, 2000
PubMed
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Serum Luteinizing Hormone (LH) is significantly lower in advanced prostate cancer (PCa) patients. This reduction is linked to the cancer itself, not androgen feedback, and normalizes after treatment.

Area of Science:

  • Endocrinology
  • Urology
  • Oncology

Background:

  • Luteinizing hormone (LH) depletion via LHRH agonists is a therapeutic strategy for hormone-sensitive prostate cancer (PCa).
  • Limited data exists on serum LH levels across different patient cohorts, including those with benign prostatic hyperplasia (BPH) and varying stages of PCa.

Purpose of the Study:

  • To investigate and compare serum LH levels in patients with PCa, BPH, and healthy controls.
  • To explore the relationship between serum LH, prostate cancer volume, Gleason score, and serum androgens.
  • To evaluate the impact of radical prostatectomy on serum LH levels.

Main Methods:

  • Serum samples were analyzed for LH, testosterone (T), dihydrotestosterone (DHT), and prostate-specific antigen (PSA) using immunological methods.

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  • Patients included those with biopsy-proven PCa, biopsy-proven BPH (absence of PCa), and specific subgroups based on PSA levels (<4 ng/ml).
  • A PCa cohort was studied before and after radical prostatectomy.

    • Main Results:

    • Significantly lower LH levels were observed in PCa patients with larger tumor volumes (>10 cm³) or higher Gleason scores compared to cancer-free controls (PSA <4 ng/ml).
    • Eight weeks post-radical prostatectomy, LH levels returned to control group levels (p<0.0001), without corresponding androgen changes.
    • The PSA/LH ratio did not significantly improve the discrimination between BPH and PCa compared to PSA or LH alone, based on ROC curve analysis.

    Conclusions:

    • Advanced forms of PCa are associated with a significant reduction in circulating LH.
    • This LH reduction is not mediated by testosterone (T) or dihydrotestosterone (DHT) feedback inhibition.
    • The healthy prostate does not significantly influence serum LH; however, advanced PCa induces a decrease in serum LH levels.