Hormonal Biomarkers in Predicting Prostate and Clinically Significant Prostate Cancer: A Prospective Study.

Area of Science:

• Endocrinology
• Urology
• Oncology

Background:

• Prostate cancer (PCa) is a leading global cancer in men.
• Prostate-specific antigen (PSA) lacks specificity for PCa diagnosis.
• Additional markers like PSA density and MRI are used, but novel biomarkers are needed.

Purpose of the Study:

• To evaluate hypothalamo-pituitary axis hormones and adrenal androgens for PCa prediction.
• To assess the role of these markers in identifying clinically significant PCa (csPCa).

Main Methods:

• Prospective cohort study of 464 men undergoing prostate biopsy.
• Analysis of prebiopsy serum levels of PSA, testosterone (TTE), LH, FSH, estradiol (EST), prolactin (PRL), testosterone density (TTEd), PSA density (PSAd), and dehydroepiandrosterone sulfate (DHEAS).
• Categorization into benign, PCa, and csPCa groups.

Main Results:

• Lower DHEAS and higher TTEd and PSAd levels were found in PCa patients.
• DHEAS levels were significantly lower in csPCa patients.
• Low DHEAS levels were associated with csPCa in men over 65.

Conclusions:

• Serum PSA alone is insufficient for PCa diagnosis.
• DHEAS and TTEd are valuable predictors of PCa and csPCa.
• Decreased DHEAS may indicate higher PCa risk, warranting further investigation.