[Serum dihydrotestosterone versus total testosterone values of patients with laryngeal carcinomas and chronic laryngitis]

Abstract

Background: Paradoxically, the highest incidence of laryngeal carcinomas occurs in the presence of reduced gonadal androgen levels associated with ageing, while the stimulating effects of androgens on the laryngeal mucosa and their tumors have been reported in the literature. The decrease of testosterone values and nearly unchanged values of dihydrotestosterone in serum and tissues of elderly men have been documented in recent endocrinological literature. This trial was performed in an effort to resolve this apparent contradiction.

Methods: Twenty-two male laryngeal cancer patients and ten patients with chronic laryngitis were examined, and their dihydrotestosterone and total testosterone values in serum recorded. Blood sampling was performed for each patient between 7 and 10 a.m. before commencement of tumor therapy. An enzyme immunoassay (Serono automat SR 1) was used to determine the values of total testosterone, whereas a 5 alpha dihydrotestosterone (H 3)- radio-immuno-assay was carried out after serum extraction.

Results: The total testosterone values of the laryngeal cancer patients were found to be significantly lower than the values in the laryngitis group, but the mean levels of dihydrotestosterone were found to be comparable within both groups. However, the scattering of dihydrotestosterone values was much higher in the group of laryngeal cancer patients than in the laryngitis group.

Conclusions: The average age of the cancer patients examined was 10 years higher than in the laryngitis group. The present results partially correspond to the reports in the endocrinological literature. Together with experimental results regarding the effects of pure substances of testosterone and dihydrotestosterone on permanent laryngeal cancer cell lines, the current results confirm the importance of the imbalance between testosterone and dihydrotestosterone as a cofactor in the development of squamous cell carcinomas of the larynx. Testosterone substitution as well as blocking of 5 alpha-reductase, the enzyme which facilitates formation of dihydrotestosterone from testosterone, are regarded as promising therapeutic opportunities for the future, especially for patients with laryngeal preneoplasias or as recurrence prophylaxis after primary tumor therapy.