Greater Percent-free Testosterone Is Associated With High-grade Prostate Cancer in Men Undergoing Prostate Biopsy
Urology, 05/22/2012Albisinni S et al.
In white Italian men, a greater percent–free testosterone (%FT) level was associated with an increased risk of high–grade prostate cancer (PCa) on initial prostate biopsy. These findings suggest that a high %FT level, rather than the absolute androgen levels, might be associated with high–grade PCa.
From 2006 to 2010, the authors collected data on 812 white Italian men with no history of PCa who underwent 12-core biopsy.
The testosterone, free testosterone, and %FT (free testosterone/total testosterone) were examined as predictors of low-grade (Gleason score of ≤6) and high-grade (Gleason score ≥7) PCa using crude and adjusted multinomial logistic regression analysis.
On multivariate analysis, testosterone (P ≥ .11) and free testosterone (P≥.45) were not significantly associated with low- or high-grade PCa.
A greater %FT level significantly predicted high-grade PCa on both crude (P=.01) and multivariate (P=.02) analysis but not low-grade PCa (P≥.38).
When examined in tertiles, men in the greatest %FT tertile had a significant twofold increased risk of high-grade PCa (odds ratio 2.04, 95% confidence interval 1.23-3.37, P=.005).
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