Androgen and oestrogen receptor status in benign and neoplastic prostate disease. Study of prevalence and influence on time to progression and survival in prostate cancer treated by hormone manipulation.

TUR chips from 89 men were analysed prospectively for androgen and oestrogen nuclear and cytoplasmic receptors (ANR, ACR, ONR, OCR). Patients were selected on the basis of suspicion of neoplastic change on clinical feel of the prostate. A control group of benign cases was also collected prospectively. Histological examination showed that 46 patients had prostatic carcinoma and 43 had benign prostatic hyperplasia. No difference was found between the 2 groups in terms of prevalence of any of the receptors or in levels of receptor in those who were positive. The patients with neoplastic changes were followed up for a median of 53 months (range 47-64). No significant effect on duration of survival was noted with any of the receptor variables but there was a beneficial association between cytoplasmic oestrogen receptor positivity and progression-free interval. Patients with T category 3 or 4 had a significantly higher chance of being ANR positive than those of lower T category and this may reflect sampling error. There appears to be some evidence to suggest that cytosol oestrogen receptor positivity has a prognostic role in prostate cancer, in terms of time to progression on hormone therapy. Receptor status did not influence survival.

Hydroxyproline excretion in the detection of occult bone metastases from breast cancer.

When surgery fails to cure breast cancer it is due to disseminated micrometastases present at the time of operation. The measurement of urinary hydroxyproline (OHP) is a possible screening test for such metastases in bone. This study compared both a single and serial urinary OHP estimation with the axillary node status, the bone scan status and the subsequent clinical course. A single measurement did not correlate with the axillary node or bone scan status, neither was there a relationship with the subsequent clinical course. Serial OHP estimations, every 3 months for a year, increased the accuracy of the test such that node-positive patients had higher excretions than node-negative patients (p less than 0.05). Patients who subsequently died with bone metastases tended to have a higher excretion than those who remained disease free, although this did not reach statistical significance. No relationship existed between serial OHP estimations and bone scan status. We consider the measurement of urinary OHP to be insufficiently sensitive to detect bone micrometastases and it is only raised when a substantial amount of bone is involved.