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Molecular Diagnostics

Urinary oestrogen steroidome as an indicator of the risk of localised prostate cancer progression

British Journal of Cancer volume 125, pages 78–84 (2021)Cite this article

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Abstract

Background

Prostate cancer (PCa) is the most common cancer in North American men. Beyond the established contribution of androgens to disease progression, growing evidence suggest that oestrogen-related pathways might also be of clinical importance. The aim of this study was to explore the association of urinary oestrogen levels with clinical outcomes.

Methods

Urine samples from the prospective multi-institutional PROCURE cohort were collected before RP for discovery (n = 259) and validation (n = 253). Urinary total oestrogens (unconjugated + conjugated), including oestrone and oestradiol, their bioactive and inactive catechol and methyl derivatives (n = 15), were measured using mass spectrometry (MS).

Results

The median follow-up time for the discovery and replication cohorts was 7.6 and 6.5 years, respectively. Highly significant correlations between urinary oestrogens were observed; however, correlations with circulating oestrogens were modest. Our findings indicate that higher levels of urinary oestriol and 16-ketoestradiol were associated with lower risk of BCR. In contrast, higher levels of 2-methoxyestrone were associated with an increased risk of development of metastasis/deaths.

Conclusions

Our data suggest that urinary levels of oestriol and 16-ketoestradiol metabolites are associated with a more favourable outcome, whereas those of 2-methoxyestrone are associated with an elevated risk of metastasis after RP. Further studies are required to better understand the impact of oestrogens on disease biology and as easily accessible urine-based risk-stratification markers.

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Fig. 1: Simplified biotransformation pathways for parent oestrogens, their bioactive and inactive catechol and methyl derivatives (n = 15) measured in this study.
Fig. 2: Correlations between urinary oestrogens in PCa.
Fig. 3: Urinary oestrogens and the risk of PCa progression.
Fig. 4: Validation of urinary oestrogens and the risk of PCa progression.

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Acknowledgements

The authors are thankful to all participating patients and staff at each site associated with the PROCURE Biobank who have made this scientific contribution possible.

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Authors and Affiliations

  1. Centre Hospitalier Universitaire (CHU) de Québec Research Center and Faculty of Medicine, Laval University, Québec, Canada

    Jean-Philippe Emond, Louis Lacombe & Eric Lévesque

  2. CHU de Québec Research Center and Faculty of Pharmacy, Laval University, Québec, Canada

    Patrick Caron, Véronique Turcotte & Chantal Guillemette

  3. Statistical and Clinical Research Platform, CHU de Québec Research Center, Québec, Canada

    David Simonyan

  4. McGill University Health Center, McGill University, Faculty of Medicine, Québec, Canada

    Armen Aprikian & Simone Chevalier

  5. Centre Hospitalier de l’Université de Montréal, Université de Montréal, Québec, Canada

    Fred Saad

  6. Université de Sherbrooke, Faculty of Medicine, Québec, Canada

    Michel Carmel

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  1. Jean-Philippe Emond
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Contributions

Study concept, design and supervision: E.L. and C.G. Steroid measurements: P.C., V.T. and C.G. Statistical analysis: D.S. Interpretation of the data: J.P.E., L.L., P.C., V.T., D.S., A.A., F.S., M.C., S.C., C.G. and E.L. Drafting of the paper: J.P.E., C.G. and E.L. Critical revision of the paper for important intellectual content: J.P.E., L.L., P.C., V.T., D.S., A.A., F.S., M.C., S.C., C.G. and E.L. Patients’ recruitment and clinical data: F.S., L.L., M.C., S.C. and A.A. Obtaining funding: E.L., C.G. and L.L.

Corresponding authors

Correspondence to Chantal Guillemette or Eric Lévesque.

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Ethics approval and consent to participate

All participants provided written informed consent and the CHU de Quebec research ethics committee approved the research protocol, and the study was performed in accordance with the Declaration of Helsinki.

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Not applicable.

Data availability

The datasets analysed during this study are available from the corresponding author on reasonable request.

Competing interests

The authors declare no competing interests.

Funding information

This work was supported by research grants from Prostate Cancer Canada (D2013-22 to E.L., C.G. and L.L.), the Cancer Research Society (to C.G.) and the Canada Research Chair Program (to C.G.). E.L. holds a CIHR Clinician-Scientist Award and was the holder of the PCC rising star award (RS2013-59). C.G. holds the Canada Research Chair in Pharmacogenomics (Tier I). The results are based on samples and patient data obtained from the PROCURE Biobank, supported by donations in a partnership with the Cancer Research Society of Canada.

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Emond, JP., Lacombe, L., Caron, P. et al. Urinary oestrogen steroidome as an indicator of the risk of localised prostate cancer progression. Br J Cancer 125, 78–84 (2021). https://doi.org/10.1038/s41416-021-01376-z

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