Low serum testosterone level does not predict bone metastasis of prostate cancer

LI Xue-bei; ZHANG Liang; RAO Tai-wen; CHEN Jie; LENG Yuan-jing; HUANG Peng

doi:10.13263/j.cnki.nja.2017.03.004

Abstract：Objective:To evaluate the role of the serum testosterone level as an independent predictor of bone metastasis of prostate cancer.Methods:This study included 165 male patients with prostate cancer confirmed by biopsy.The patients were aged 58-78 (66.6 ± 5.3) years and none had received androgen-deprivation therapy,chemotherapy or radiotherapy previously.We obtained the baseline clinical data from the patients,including prostate biopsy Gleason scores and the levels of serum prostate-specific antigen (PSA),total testosterone (TT),luteinizing hormone (LH),follicle-stimulating hormone (FSH),estradiol (E2),alkaline phosphatase (ALP) and prolactin.According to the results of bone scanning,we divided the patients into a bone metastasis and a nonbone metastasis group and screened out the differential factors by univariate analysis and the independent predictor of bone metastasis using the multivariate non-conditional logistic regression model.Results:Univariate analysis showed no statistically significant differences between the bone metastasis and non-bone metastasis groups in age (P =0.126) or the levels of serum LH (P =0.930),FSH (P =0.763) and E2 (P =0.256),but that the former had remarkably higher Gleason scores (P ＜ 0.01),total PSA (P ＜ 0.01) and ALP (P ＜ 0.01) but a lower TT level than the latter (P =0.013).According to the results of multivariate logistic regression analysis,serum ALP(P ＜0.01,OR =1.018 [1.011-1.026]) and totalPSA (P ＜0.01,OR =1.029 [1.015-1.044]) could be regarded as independent predictors of bone metastasis of prostate cancer but not low serum TT (P =0.531,OR =0.999 [0.996-1.002]) or biopsy Gleason score (P =0.898,OR =0.787 [0.412-1.9559]).Conclusion:The low level of serum testosterone is closely associated with but not an independent predictor of bone metastasis of prostate cancer.