Gender differences in hormonal statuses of patients with esophageal squamous cell carcinoma.

85 Background: Esophageal squamous cell carcinoma (ESCC) is 4-8 times more frequent in men than in women, with poorer prognosis. The purpose of the study was to analyze systemic and local hormonal statuses in patients with ESCC in dependence on their gender. Methods: The study included 34 ESCC (G2, рT1-2N0-1M0) patients: 21 men and 13 women. 11 men (52.4%) had lymph node metastases. Levels of sex steroids – total (T) and free (fT) testosterone, progesterone (P4), estradiol (E2), estrone (E1), prolactin (PRL), LH, FSH and sex steroid-binding globulin (SSBG) – were studied in the peripheral blood, tumor and resection line by the standard RIA and ELISA methods. Results: Men showed a decrease in the blood T concentration by 1.4 times, P4 by 2 times, and E2 increase by 2.5 times, while women showed 1.3 times increase in T and 2 times decrease in P4. Metastases in men were accompanied by an increase in blood levels of anterior pituitary hormones: PRL by 2.5 times, LH by 2.3 times and FSH by 2.2 times compared to patients without metastases. Analysis of the local saturation with sex hormones in visually unchanged esophageal tissues of ESCC patients did not reveal any significant gender difference. However, women were characterized by a higher content of anterior pituitary hormones, PRL, LH and FSH, in esophageal tissues compared to men. Men with metastases showed local hyper-androgenization of tumor and surrounding tissues, as the fT to E1 ratio was increased. Conclusions: The results confirmed the data on T-stimulation of malignant growth in the esophagus and the possible protective effect of estrogens. The free testosterone to estrogens ratio in esophageal tissues can probably serve as one of prognostic factors for the disease course.