Serum androgens and gonadotrophins in bronchial carcinoma

The concentrations of testosterone, free testosterone index derived by two independent techniques (FTI1, FTI2), dehydroepiandrosterone sulphate (DHAS), androstenedione (AND), luteinizing hormone (LH), follicle stimulating hormone (FSH), and sex hormone binding globulin (SHBG) were measured in 38 healthy male controls aged between 40 and 60 years (Group 1) and in 52 male patients with bronchial carcinoma of whom 28 were aged between 40 and 60 years (Group 2) and 24 were aged over 60 years (Group 3). Compared with Group 1, testosterone, FTI1, FTI2, and DHAS were significantly lower (P < 0.001), AND and LH were significantly higher (P < 0.001) and there was no significant difference in FSH or SHBG, in Group 2. No significant difference between Groups 2 and 3 was found for any variable. Analysis of covariance for Groups 2 and 3 combined, showed testosterone, FTI1 and FTI2 were significantly lower in the presence of metastases. These results suggest a more widespread abnormality of androgen metabolism in male patients with bronchial carcinoma than a simple reduction in serum testosterone; DHAS is also significantly reduced while AND is significantly increased. The primary abnormality appears to be at testicular and/or adrenal level as pituitary function appears normal as witnessed by compensatory increases in LH.