Journal of Postgraduate Medicine
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ARTICLE
 
 
Year : 1977  |  Volume : 23  |  Issue : 4  |  Page : 172-174  

Observations on urinary 17-ketosteroids in breast cancer patients

RK Singh, KN Udupa 
 Surgical Research Laboratory, Institute of Medical Sciences, Banaras Hindu University, Varanasi-221 005., India

Correspondence Address:
R K Singh
Human Metabolism Department, Medical College, Meerut-250102.
India

Abstract

Urinary 17-ketosteroids (17-KS) have been estimated and correlated with different stages of breast cancer in this study. We observed marked increase in urinary 17-KS in advanced stages of the disease. Further, we noticed a positive correlation between urinary 17-KS levels and the progress of the disease. Thus, estima­tion of urinary 17-KS may prove to be of some prognostic value and may help the clinicians concerned in the clinical evaluation of the stage and the progress of the disease.



How to cite this article:
Singh R K, Udupa K N. Observations on urinary 17-ketosteroids in breast cancer patients.J Postgrad Med 1977;23:172-174


How to cite this URL:
Singh R K, Udupa K N. Observations on urinary 17-ketosteroids in breast cancer patients. J Postgrad Med [serial online] 1977 [cited 2021 Apr 15 ];23:172-174
Available from: https://www.jpgmonline.com/text.asp?1977/23/4/172/42746


Full Text

 Introduction



Urinary corticosteroids have been re­ported to be altered in breast cancer pati­ents. [1],[3],[7] The changes in the ratio of urinary 11-deoxy-17-oxosteroids and 17­hydroxycorticosteroids (17-OHCS) have been found to be valuable in predicting the progress after adrenalectomy or hypophysectomy in these patients. [10] However, little is known about urinary 17-KS in difference stages of breast can­cer. Recently we have reported elevated levels of plasma 17-OHCS in all the pati­ents of breast cancer irrespective of the stage of the disease and have noticed a direct correlation between plasma 17­OHCS levels and the progress of the disease. [9],[11] In the present study an at­tempt has been made to investigate and correlate urinary 17-KS levels with diffe­rent stages of breast cancer.

 Material and Methods



Eighty breast cancer patients have been included in this study. The ages of these patients ranged between 20 and 76 years. Detailed clinical history of each patient was recorded. Routinely radiological examination of the chest was done in all cases. Histological examination of breast and auxiliary lymph nodes was carried out. Most of these patients presented with clinical features like lump in breast, nipple discharge, lump in axilla and neck and ulcerations. However, these features were variable. The clinical staging of these patients was done according to the Manchester system. [8] There were 23, 14, 16 and 27 patients in the first, second, third and fourth stages respectively. 15 normal healthy female volunteers were also in­cluded in this study who served as con­trols,

24 hours' urine of each patient was col­lected in a given polythene container and total volume was recorded. Conc. HCL was used as preservative. Urinary 17-KS was estimated using the standard proce­dure as described by King and Wotton. [6]

 Results



Patients suffering from first stage of breast cancer did not exhibit any signi­ficant change in urinary 17- KS levels when compared with normals (p>0.05). However, we observed marked increase in urinary 17-KS levels in patients suffering from second, third and fourth stages of the disease (p 1 2 3 ) [Table 1].

r 1 , r 2 and r 3 were computed between 14, 14 and 16 patients respectively.

 Discussion



We observed significantly elevated levels of urinary 17-KS in patients suffer­ing from second, third and fourth stages of breast cancer. However, urinary 17­-KS levels did not exhibit any significant change in patients suffering from first stage of the disease.

Beck et al [2] have reported low levels of urinary 17-KS in patients with meta­static carcinoma of the breast. In several other investigations also the urinary ex­cretion of androgen metabolites including dehydroepiandrosterone has been found to be subnormal in advanced stages of breast cancer . [4],[5] According to Miller et al [7] useful diagnostic information can be obtained by determining 11-deoxy-17­oxosteroids together with 17-OHCS. It has been reported by earlier investigators that the estimation of total urinary 17­KS have no clinical importance in breast cancer patients. However, our findings are quite different from the above men­tioned reports. We noticed marked in-­crease in urinary 17-KS levels in advanced stages of the disease.. Elevated levels of urinary 17-KS in breast cancer patients as observed by us might be due to an increased production of corticoids which is evident by increased levels of plasma 17-OHCS in these patients. [9],[11] Presum­ably degradation of corticosteroids might have increased in these patients resulting into increased 17-KS as observed in the present study. We are not aware of any study in which increase in urinary 17-KS levels have been correlated with the ad­vancing stage of breast cancer. However, in this study we also noticed a direct correlation between urinary 17-KS levels and the progress of the disease (r 1 2 3 ). Thus, we feel that the estimation of urinary 17-KS may also prove to be of some prognostic value and may help the clinicians concerned in the clinical evaluation of the stage and the progress of the disease.

References

1Allen, B. J., Hayward, J. L. and Meri­vale, W. H. H.: The excretion of 17­ ketosteroids in urine of patients with gene­ralized carcinomatosis secondary to carci­noma of the breast. Lancet, 1: 496-499. 1957.
2Beck, J. C., Casey. J., Sclomon, S. and Hoffman, M. M.: In the human adrenal cortex. Ed. by Wolstenholme, G. E. W. and Porter, R. Ciba Found. Study Group No. 27, p. 94, 1967­
3Bulbrook, R. D., Haywards, J. L., Spi­ces, C. C. and Thomas, B. S.: Abnormal excretion of urinary steroids by women with early breast cancer. Lancet, 2: 1238­-1240, 1962­
4Cameron, E. H. D., Griffiths, K., Gleave, E. N., Stewart, H. J., Forrest, A. P. M. and Campbell, H.: Benign and malignant breast disease in Southwales. A study cf urinary steroids. Brit. Med. J., 4: 768­771, 1970.
5Gutierrez, R. M. and Williams, R. J.: Excretion of ketosteroids and proneness to breast cancer. Proc. Nat. Acad. Scs., 59: 938-943, 1968.
6King, E. J. and Wootton, I. D. P.: In "Microanalysis in Medical Biochemistry". J. & A. Churchil Ltd., 4th Edition. London, p. 177, 1964.
7Miller, H., Durant, J. A., Jacobs, A. G. and Allison, J. F.: Alternative discrimi­nating function for determining hormone dependency of breast cancer. Brit. Med. J., 1: 147-149, 1967.
8Paterson, R.: In the treatment of malig­nant disease by radium and X-rays. Arnold. London, 1948, p. 309.
9Singh, R. K., Bharthan, K., Chansouria, J. P. N., Khanna, N. N. and Udupa, K. N.: Adrenocortical function in breast cancer. Ind. J. Med. Res., 64: 1780-1.782., 1976.
10Stern, E., Hopkins, C. W., Weiner, J. M. and Marmorston, J.: Hormone excre­tion patterns in breast and prostate cancer are abnormal. Science, 145: 716-719, 1964.
11Udupa, K. N., Singh, R. K., Bharthan, K., Chansouria, J. P. N. and Khanna, N. N.: Plasma cortisol (17-OHCS) levels in different stages o`' breast cancer. Intern, Res. Commun. System 1 (No. 7) 33, 1973.

 
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