前列腺癌药物去势后血清激素水平早期变化

Early changes of serum hormones in prostate cancer patients with medical castration

目的 :通过检测前列腺癌患者药物去势早期血清中激素水平 ,了解与前列腺癌疗效有关的激素变化情况并探讨相关问题 ;方法 :6例前列腺腺癌患者 (D期 ) ,每月皮下注射LHRH类似物 1次 ,并于第 0、1、3、5、7、10天及第 2、3、4、6、8、12周分别抽血测定血清中睾酮 (testosterone,T)、黄体生成素 (luteinizinghormone,LH)、雌二醇(estradiol,E2 )、卵泡刺激素 (follicle stimulatinghormone ,FSH)水平 ;结果 :基础值 :T(6 78.0± 2 4.8)ng·L-1,E2(2 7.4± 5 .4)ng·L-1,LH (13.6± 2 .8)IU·L-1,FSH (12 .9± 4.2 )IU·L-1;最高值 :LH(第 3天 ) (32 .6± 3.4)IU·L-1,T(第 3天 ) (1176 .0± 35 .7)ng·L-1,E2 (第 5天 ) (75 .0± 8.4)ng·L-1,FSH(第 5天 ) (2 3.0± 4.2 )IU·L-1;此后激素水平急速下降 ,降至基础值以下 :LH(第 10天 ) (9.8± 3.6 )IU·L-1,T(第 10天 ) (2 31.5± 2 8.6 )ng·L-1,E2 (第 14天 ) (2 4.2± 6 .7)ng·L-1,FSH(第 10天 ) (7.1± 3.3)IU·L-1;T在第 2 1天左右达到去势水平 (38.7± 4.6 )ng·L-1;结论 :药物去势后血清睾酮出现一过性升高 ,最高可达基础值的 1.7倍 ,然后迅速下降 ,3周左右达到去势水平 ;雌激素水平在用药后也有一过性升高 ,但与睾酮升高不同步 ,提示在治疗最初

Objective: To understand the early changes of sexual hormones in prostate cancer patients with medical castration. Methods: A subcutaneous depot injection of LHRH agonist (Zoladex) was instituted every month for six stage D prostate cancer patients, and the serum testosterone(T), estradiol(E 2), luteinizing hormone(LH) and follicle stimulating hormone(FSH) were detected in days 0,1,3,5,7,10 and weeks 2,3,4,6,8,12 separately. Results: Baseline: T( 678.0±24.8) ng·L -1 ,LH( 13.6±2.8) IU·L -1 ,E2 (27.4±5.4) ng·L -1 , FSH(12.9±4.2) IU·L -1 ; peak value: LH(Day 3)(32.6±3.4) IU·L -1 ,T(Day 3)(1176.0±35.7)ng·L -1 ,E2(Day 5) (75.0±8.4)ng·L -1 , FSH(Day 5)(23.0±4.2)IU·L -1 ; under baseline: LH(Day 10)(9.8±3.6) IU·L -1 , T(Day 10) (231.5± 28.6 ) ng·L -1 , E2(Day 14)(24.2±6.7)ng·L -1 ,FSH(Day 10) (7.1±3.3)IU·L -1 ; and castrated level of serum testosterone was detected after 21 days(38.7±4.6) ng·L -1 . Conclusion: After medical castration, the serum testosterone level showed temporary elevation, the ration of the peak value/baseline was 1.7; and then the testosterone level decreased sharply. The temporary high estradiol level was also found, but it is later for estradiol peak value than that in the testosterone detection, Which suggests that estrogen and androgen blocker were the accompanying drugs during the first ten days. The temporary elevation was found during the detection of serum LH and FSH. ( J Beijing Med Univ, 2000,32:170 171 )