New study below.
I continue to see comments about testosterone [T] driving PCa, so I post contrarian studies as they turn up. This is not cherry picking, since high-normal T has never been associated with risk, compared to low-normal T.
"We retrospectively reviewed 92 patients with benign prostatic hyperplasia (BPH) and 164 patients with PCa treated at Zhongshan Hospital, China (April 2012 to November 2013)."
Patients with PCa and PSA >20 ng/ml had lower testosterone (12.9 versus 17.5 ng/ml).
Patients with PCa and PSA >20 ng/ml had lower T/PSA (0.29 versus 2.24).
Patients with PCa and Gleason score >7 had lower testosterone (14.1 versus 18.3 ng/ml).
In patients with PSA ≤20 ng/ml, T/PSA was lower in those with PCa than in those with BPH (2.24 versus 4.69).
"T/PSA may improve the accuracy of PCa diagnosis in patients with a PSA level ≤20 ng/ml."
-Patrick
onlinelibrary.wiley.com/wol...
Summary
We investigated whether serum testosterone and testosterone/prostate-specific antigen ratio (T/PSA) might be prostate cancer (PCa) biomarkers. We retrospectively reviewed 92 patients with benign prostatic hyperplasia (BPH) and 164 patients with PCa treated at Zhongshan Hospital, China (April 2012 to November 2013). The BPH and PCa groups had similar serum total testosterone (median, 15.8 versus 16.3 nmol/L).Compared with the BPH group, the PCa group had higher PSA (16.8 versus 5.1 ng/ml) and lower free/total PSA (9.5% versus 19.3%) and T/PSA (1.37 versus 4.69) (all p < .001).Patients with PCa and PSA ≤20 ng/ml had higher testosterone (17.5 versus 12.9 ng/ml; p = .002) and T/PSA (2.24 versus 0.29; p < .001) than those with PSA >20 ng/ml. Patients with PCa and Gleason score ≤7 had higher testosterone (18.3 versus 14.1 ng/ml; p = .023) and T/PSA (1.93 versus 0.72; p < .001) than those with Gleason score >7. In patients with PSA ≤20 ng/ml, T/PSA was higher in those with BPH than in those with PCa (4.69 versus 2.24; p < .001). ROC curve analysis yielded an AUC of 0.712; for the optimal cut-off of 4.43, specificity and sensitivity were 52% and 97% respectively. T/PSA may improve the accuracy of PCa diagnosis in patients with a PSA level ≤20 ng/ml.