Cociente digital 2D:4D y distancia anogenitalRelación con el cáncer de próstata y volumen prostático

Abstract

Introduction: the prostate is a walnut-shaped organ, exclusive in men, which is located at base of the urinary bladder. Its alteration can cause serious health problems, mainly prostate cancer and prostate hypertrophy. It is an organ whose functioning and development depends on hormones, mainly testosterone. Testosterone is mainly produced by testicular Leydig cells, with two peaks throughout life: one is produced by fetal Leydig cells during masculinization fetal period and the other one is produced by adult Leydig cells in the prepuberal period up to the end of puberty. On the other hand, 2D:4D digit ratio and anogenital distance (AGD) are two biomarkers which are estabilished during fetal development, remaining practically stable during adulthood, and reflect the fetal androgen environment. The aim of our study was to analyze the relationship between 2D:4D and the risk of prostate cancer and the relationship between 2D:4D and AGD with prostate size. Material and methods: we carried out a case-control study between may 2013 and july 2015 at the Reina Sofía University General Hospital's Urology department, in Murcia. The cases were patients who underwent a radical prostatectomy for prostate cancer and the controls were healthy patients who attended the Urology department for other reasons. We registered information about medical history and family medical history, and measured the length of the second and four fingers on the right hand and the anogenital distance, which was measured in two variants [from the base of the penis to the upper anal margin (AGGAP) and from the root from the scrotum to the superior anal margin (AGDAS)]. Subsequently, a subpopulation of the study, including only cases, was used to evaluate associations between 2D:4D and AGDs measurements and prostate size. For this multiple linear and logistic regression models were employed using appropriate statistical software. Results: we observed that patients with a low digit ratio had an increased risk of prostate cancer. Those patients who were in the first tertile had a double risk of prostate cancer compared with those in the joint second and third tertiles [adjusted OR: 1.9 (95% CI: 1.1 ; 4.0 (p = 0.040))]. Regarding prostate size, we did not find statistically significant results with de digit ratio, although there was a borderline statistical trend between the length of the fourth finger and prostate size if we divided pacients according to their family history of prostate cancer [? = 0.994, 95% CI = -0.119 ; 2.107 (p = 0.077)]. Moreover, we found a significant relationship between AGD and prostate size if we considered prostate cancer family history but with an inverse relationship if they had family history or not [? = -0.551, 95% CI = -1.007 ; - 0.095 (p = 0.02); ? = 0.332; 95% CI = 0,087 ; 0.557 (p = 0,009), respectively]. Conclusions: both, cancer and prostate hypertrophy are two health problems whose incidence is increasing and can affect men's quality of life. We have observed that 2D:4D is a useful biomarker that could be used as tool for prediction of pacientes who can have prostate cancer. AGD -mainly in patients witn no family history of prostate cancer- could be used as a biomarker to predict pathological growth of the prostate.