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Metabolic alteration of urinary steroids in pre- and post-menopausal women, and men with papillary thyroid carcinoma

  • Man Ho Choi1,
  • Ju-Yeon Moon1,
  • Sung-Hee Cho1,
  • Bong Chul Chung1Email author and
  • Eun Jig Lee2
BMC Cancer201111:342

DOI: 10.1186/1471-2407-11-342

Received: 7 March 2011

Accepted: 8 August 2011

Published: 8 August 2011

Abstract

Background

To evaluate the metabolic changes in urinary steroids in pre- and post-menopausal women and men with papillary thyroid carcinoma (PTC).

Methods

Quantitative steroid profiling combined with gas chromatography-mass spectrometry was used to measure the urinary concentrations of 84 steroids in both pre- (n = 21, age: 36.95 ± 7.19 yr) and post-menopausal female (n = 19, age: 52.79 ± 7.66 yr), and male (n = 16, age: 41.88 ± 8.48 yr) patients with PTC. After comparing the quantitative data of the patients with their corresponding controls (pre-menopause women: n = 24, age: 33.21 ± 10.48 yr, post-menopause women: n = 16, age: 49.67 ± 8.94 yr, male: n = 20, age: 42.75 ± 4.22 yr), the levels of steroids in the patients were normalized to the mean concentration of the controls to exclude gender and menopausal variations.

Results

Many urinary steroids were up-regulated in all PTC patients compared to the controls. Among them, the levels of three active androgens, androstenedione, androstenediol and 16α-hydroxy DHEA, were significantly higher in the pre-menopausal women and men with PTC. The corticoid levels were increased slightly in the PTC men, while progestins were not altered in the post-menopausal PTC women. Estrogens were up-regulated in all PTC patients but 2-hydroxyestrone and 2-hydroxy-17β-estradiol were remarkably changed in both pre-menopausal women and men with PTC. For both menopausal and gender differences, the 2-hydroxylation, 4-hydroxylation, 2-methoxylation, and 4-methoxylation of estrogens and 16α-hydroxylation of DHEA were differentiated between pre- and post-menopausal PTC women (P < 0.001). In particular, the metabolic ratio of 2-hydroxyestrone to 2-hydroxy-17β-estradiol, which could reveal the enzyme activity of 17β-hydroxysteroid dehydrogenase, showed gender differences in PTC patients (P < 1 × 10-7).

Conclusions

These results are expected be helpful for better understanding the pathogenic differences in PTC according to gender and menopausal conditions.

Keywords

Steroids Thyroid cancer Menopause Gender difference GC-MS

Background

Papillary thyroid carcinoma (PTC) is the commonest of all thyroid carcinomas and is well-differentiated. The incidence of PTC is three times higher in women than men [1, 2] but this gender difference decreases after menopause [3]. The gender differences and menopausal conditions in the incidence of PTC suggest that the pathogenesis and development of PTC might be affected by sex steroids, particularly androgens and estrogens [311].

The biological activity of estrogens is differentiated by an interaction with both estrogen receptors α and β (ERα and ERβ). Especially, the level of ERα is higher in PTC cells than other thyroid carcinoma cells and normal cells [12]. In addition, the level of ERα is higher in pre-menopausal women than in post-menopausal women and men with PTC [7]. The androgen receptor (AR), which mediates the biological activity of androgens, can be identified in human thyroid cells [1316]. The levels of AR in thyroid cells are higher in men than in women, and higher in PTC cells than in normal cells [1416].

Although sex steroids including estrogens and androgens might be associated with both the growth and progression of PTC, the changes in steroids along with gender differences and menopause in PTC have not been well defined. No data is available on the metabolic alteration of steroid profiling between pre- and post-menopausal women, and men with PTC. Therefore, in this study, 84 steroids (including 25 androgens, 17 estrogens, 23 corticoids, 14 progestins, and 5 sterols) in urine samples obtained from pre- and post-menopausal women, and men with PTC were evaluated against the corresponding control groups matched for gender and menopausal condition using gas chromatography-mass spectrometry (GC-MS)-based steroid signatures [17]. Firstly, the urinary levels of steroids in the PTC patients and their controls in the three groups (pre- and post-menopausal women and men) were measured and significance in the individual groups was evaluated using a Student's t-test. Secondly, the steroid levels in each patient group were normalized to those of the corresponding controls to exclude the nature of menopausal and gender differences. The change in normalized steroids profiling between the three groups was evaluated by one-way variance analysis (one-way ANOVA). Finally, the metabolic patterns of steroids in the three groups were interpreted by partial least-squares-discrimination analysis (PLS-DA), and examined by ANOVA.

Methods

Subjects and sample-collection

Urine samples were collected from pre-menopausal women (n = 21, age: 36.95 ± 7.19 yr, BMI: 23.72 ± 4.69 kg/m2), post-menopausal women (n = 19, age: 52.79 ± 7.66 yr, BMI: 24.46 ± 2.76 kg/m2) and men (n = 16, age: 41.88 ± 8.48 yr, BMI: 25.52 ± 3.31 kg/m2) with PTC as well as from healthy subjects as the controls for the pre-menopausal women (n = 24, age: 33.21 ± 10.48 yr, BMI: 23.52 ± 3.94 kg/m2), post-menopausal women (n = 16, age: 49.67 ± 8.94 yr, BMI: 23.02 ± 3.38 kg/m2) and men (n = 20, age: 42.75 ± 4.22 yr, BMI: 24.58 ± 2.49 kg/m2) at the Severance Hospital (Seoul, Korea). All study subjects underwent the same diagnostic procedures, i.e., ultrasound and fine needle aspiration (FNA) as detailed by the American Joint Committee on Cancer staging. Patients with a history of cancer of the cervix, breast, endometrium, or head and neck, and respiratory papillomatosis as well as the post-menopausal women, who have received the estrogen replacement therapy, were excluded. The PTC not invaded the adjacent tissues or showed no spread to nearby lymph nodes. The healthy gender- and age-matched controls had no evidences of benign or malignant thyroid diseases. The first morning urine samples were collected after fasting for at least 12 hours and the patient samples were taken before thyroidectomy. All subjects showed normal thyroid function (T3: 104.11 ± 19.1 ng/dL, T4: 11.16 ± 2.56 μg/dL, TSH: 1.02 ± 0.31 μIU/mL) and were not treated with or exposed to any drugs including the contraceptive. The experimental protocol (4-2009-0424) was approved by the IRB Committee of the Human Research Protection Center at the Severance Hospital and an informed consent was signed by all subjects. The levels of urinary steroids were calibrated by the creatinine values using Jaffé's method [18].

Chemicals and materials

The reference standards of the 84 steroids examined in this study (Table 1) were obtained from Sigma (St. Louis, MO), Steraloids (Newport, RI), and NARL (Pumble, Australia). The internal standards, 16,16,17-d 3-testosterone and methyltestosterone for 25 androgens, 2,4,16,16-d 4-estradiol for 17 estrogens, 9,11,12,12-d 4-cortisol for 23 corticoids, 2,2,4,6,6,17α,21,21,21-d 9-progesterone and 2,2,4,6,6,21,21,21-d 8-17α-hydroxyprogesterone for 14 progestins, and 2,2,3,4,4,6-d 6-cholesterol for 5 sterols were purchased from NARL and C/D/N isotopes (Pointe-Claire, Quebec, Canada). For solid-phase extraction (SPE), an Oasis HLB cartridge (3 mL, 60 mg; Waters, Milford, MA) was preconditioned with 3 mL of methanol followed by 3 mL of deionized water. Sodium acetate (reagent grade), acetic acid (glacial, 99.99+%) and L-ascorbic acid (reagent grade) were obtained from Sigma. A solution of β-glucuronidase was purchased from Roche Diagnostics GmbH (Mannheim, Germany). The trimethylsilylating (TMS) agents, N-methyl-N-trifluorotrimethylsilyl acetamide (MSTFA), ammonium iodide (NH4I), and dithioerythritol (DTE) were purchased from Sigma. All organic solvents used were of analytical or HPLC grade and were purchased from Burdick & Jackson (Muskegan, MI). Deionized water was prepared using a Milli-Q purification system (Millipore; Billerica, MA).
Table 1

Concentrations of urinary steroids in pre-menopausal PTC women and control

Steroids

Concentrationa (mean ± SD)

P-value

 

Controls

(n = 24)

PTC

(n = 21)

Controls : PTC

Androgens

   

Dihydrotestosterone

65.79 ± 47.43

118.67 ± 61.89

< 0.005

Epidihydrotestosterone

20.21 ± 16.70

44.85 ± 18.85

< 0.0007

Dehydroepiandrosterone

151.34 ± 84.40

216.29 ± 93.00

< 0.02

Testosterone

64.73 ± 45.54

116.60 ± 24.77

< 0.03

Epitestosterone

82.61 ± 49.75

109.66 ± 42.13

NSb

5α-androstan-3α,17β-diol

137.28 ± 90.96

202.60 ± 259.73

NS

5α-androstan-3β,17β-diol

20.00 ± 11.75 (3)

42.54 (1)

NCc

5β-androstan-3α,17β-diol

204.52 ± 149.53

248.07 ± 336.60

NS

5β-androstan-3α,17α-diol

70.50 ± 49.49

107.26 ± 105.68

NS

5β-androstan-3β,17α-diol

5.42 ± 1.69 (4)

6.30 ± 1.45 (3)

NC

5α-androstan-3β,17α-diol

21.17 ± 14.55

41.20 ± 28.43

NS

5α-androstan-3α,17α-diol

33.64 ± 26.33

53.18 ± 41.56

NS

5β-androstan-3β,17β-diol

8.75 (1)

36.84 ± 53.75 (4)

NC

Androstenedione

59.17 ± 50.56

96.93 ± 39.56

< 0.01

Androstenediol

51.71 ± 31.61

96.27 ± 33.98

< 0.0002

Androsterone

7826.70 ± 5459.40

24675.61 ± 23074.97

< 0.004

Etiocholanolone

7074.80 ± 4371.84

21993.33 ± 14558.44

< 0.0002

11-keto-androsterone +

11-keto-etiocholanolone

439.95 ± 320.79

2048.15 ± 1749.63

< 0.0005

11β-hydroxyandrosterone

2413.61 ± 1411.53

5197.95 ± 4501.89

< 0.01

11β-hydroxyetiocholanolone

1185.01 ± 873.09

2598.36 ± 1740.91

< 0.003

5β-dihydrotestosterone

3.97 ± 2.92

21.71 ± 9.26

< 0.00008

16α-hydroxy-DHEA

127.76 ± 67.50

285.48 ± 147.21

< 0.0002

Epiandrosterone

33.26 ± 26.59

49.45 ± 29.48

NS

5α-Androstanedione

36.43 ± 15.15 (11)

59.43 ± 12.34 (4)

NC

Estrogens

   

Estrone

71.16 ± 60.17

165.12 ± 138.61

< 0.008

17β-estradiol

20.78 ± 19.43

52.64 ± 42.82

< 0.008

Estriol

69.12 ± 55.60

197.03 ± 403.37

NS

2-hydroxyestrone

298.38 ± 272.41

126.11 ± 63.97

< 0.007

2-hydroxy-17β-estradiol

84.88 ± 60.34

283.06 ± 247.77

< 0.002

4-hydroxyestrone

72.78 ± 57.37

119.25 ± 54.27

< 0.02

4-hydroxy-17β-estradiol

37.69 ± 30.34

91.53 ± 49.54

< 0.0003

2-methoxyestrone

53.79 ± 96.35

94.21 ± 48.47

NS

2-methoxy-17β-estradiol

28.85 ± 23.85

43.09 ± 18.79

NS

4-methoxyestrone

36.30 ± 32.13

61.86 ± 29.64

< 0.04

4-methoxy-17β-estradiol

29.38 ± 19.95

61.79 ± 37.91

< 0.02

17-epiestriol

18.07 ± 8.07

97.53 ± 56.54

< 0.003

16-epiestriol

37.43 ± 16.97

83.48 ± 68.51

< 0.02

17α-estradiol

2.18 ± 1.98 (2)

ND

NC

2-hydroxyestriol

2.37 ± 2.74

85.99 ± 63.04

< 0.002

16-keto-17β-estradiol +

16α-hydroxyestrone

20.79 ± 11.75

70.92 ± 81.33

< 0.01

Corticoids

   

Cortisol

276.27 ± 348.99

194.98 ± 121.70

NS

Allodihydrocortisol

38.87 ± 26.40

24.27 ± 18.96

NS

Corticosterone

37.33 ± 28.36

54.26 ± 24.03

NS

Allodihydrocorticosterone

33.18 ± 26.19

42.48 ± 18.15

NS

Dihydrodeoxycorticosterone

97.57 ± 145.03

90.54 ± 53.46

NS

11-deoxycorticosterone

43.68 ± 27.30

48.25 ± 19.29

NS

11-deoxycortisol

59.55 ± 42.52

53.88 ± 37.00

NS

Cortisone

700.66 ± 691.13

828.94 ± 783.61

NS

Allotetrahydrocortisol

6987.19 ± 6000.57

14415.42 ± 17559.79

NS

21-deoxycortisol

69.17 ± 45.07

89.61 ± 80.03

NS

11-dehydrocorticosterone

131.08 ± 121.05

92.97 ± 93.87

NS

Tetrahydrodeoxycortisol

502.93 ± 336.31

547.57 ± 293.54

NS

Tetrahydrocortisone

12623.53 ± 9093.38

14081.85 ± 11546.70

NS

Tetrahydrocortisol

6038.33 ± 4364.60

10488.74 ± 9218.05

NS

Tetrahydrodeoxycorticosterone

72.07 ± 90.74

76.89 ± 88.78

NS

Tetrahydrocorticosterone

353.41 ± 307.84

589.34 ± 321.77

< 0.02

11-dehydrotetrahydrocorticosterone

1403.89 ± 610.28

992.50 ± 677.32

NS

α-cortolone

4989.28 ± 3076.48

5749.11 ± 3617.93

NS

β-cortolone

2030.16 ± 1204.44

2745.91 ± 1714.17

NS

20α-dihydrocortisone

340.09 ± 272.98

423.71 ± 252.98

NS

α-cortol

921.30 ± 645.85

884.54 ± 634.69

NS

β-cortol

2296.04 ± 1382.42

2602.54 ± 1638.69

NS

20α-dihydrocortisol

209.95 ± 260.36

130.72 ± 105.39

NS

Progestins

   

Pregnenolone

44.36 ± 33.00

73.78 ± 32.67

< 0.008

Progesterone

45.35 (1)

194.29 (1)

NC

5β-dihydroprogesterone

7.23 ± 5.09

7.88 (1)

NC

5α-dihydroprogesterone

53.83 ± 26.13

20.36 ± 25.60

< 0.04

20α-hydroprogesterone

125.50 ± 189.43

153.23 ± 126.74

NS

Epipregnanolone

19.10 ± 17.42

29.50 ± 12.29

NS

Pregnanolone

717.51 ± 900.30

1305.74 ± 2701.21

NS

Allopregnanolone

198.24 ± 255.64

188.66 ± 240.25

NS

Isopregnanolone

33.41 ± 13.44

73.87 ± 50.59

< 0.02

Pregnanediol

7025.27 ± 8837.04

14031.18 ± 31235.57

NS

Pregnanetriol

2874.08 ± 1477.34

5021.37 ± 4085.30

< 0.04

17α-hydroxypregnenolone

57.89 ± 42.96

87.99 ± 40.07

< 0.03

17α-hydroxyprogesterone

53.61 ± 43.13 (6)

97.95 ± 63.76 (2)

NC

11β-hydroxyprogesterone

938.19 ± 726.72

1557.51 ± 1150.75

< 0.05

Sterols

   

Cholesterol

4601.20 ± 9878.96

7633.19 ± 8383.76

NS

Desmosterol

167.78 ± 64.99

327.76 ± 127.00

NS

Lanosterol

76.86 ± 82.14

78.06 (1)

NC

20α-hydroxycholesterol

59.65 ± 52.14

93.08 ± 24.37

NS

24S-hydroxycholesterol

53.36 ± 35.45

66.87 ± 30.67

NS

The number in the parentheses is the number of subject detected corresponding steroid.

aConcentrations are expressed as ng/g of creatinine (mean ± SD).

bNS, not significant.

cNC, not comparable.

Sample preparation

Quantitative steroid profiling was performed using a previous technique [17]. Briefly, a urine sample (2 mL) spiked with 20 μL of 7 internal standards (d 3-testosterone and d 4-estradiol: 1 μg/mL, d 4-cortisol and d 8-17α-hydroxyprogesterone: 5 μg/mL, methyltestosterone, d 9-progesterone and d 6-cholesterol: 10 μg/mL) was loaded into the Oasis HLB™ SPE cartridge and washed with 2 mL water. After elution twice with 2 mL of methanol, the combined methanol was evaporated under a stream of nitrogen and 1 mL of 0.2 M acetate buffer (pH 5.2), 100 μL of 0.2% L-ascorbic acid, and 50 μL of β-glucuronidase were then added. After incubation at 55°C for 3 h, the solution was extracted twice with 2.5 mL of ethyl acetate: n-hexane (2:3, v/v). The combined organic solvents were evaporated using a N2 evaporator at 40°C and dried further in a vacuum desiccator over P2O5-KOH for at least 30 min. Finally, the dried residue was derivatized with MSTFA/NH4I/DTE (40 μL; 500:4:2, v/w/w) at 60°C for 20 min, and 2 μL of the resulting mixture was subjected to GC-MS in selected-ion monitoring (SIM) mode.

Instrumental conditions

GC-MS was performed using an Agilent 6890 Plus gas chromatograph interfaced with a single-quadrupole Agilent 5975 MSD at an electron energy of 70 eV and ion source temperature of 230°C. Each sample (2 μL) was injected in split mode (10:1) at 280°C and separated through an Ultra-1 capillary column (25 m × 0.2 mm i.d., 0.33 μm film thickness; Agilent Technologies; Palo Alto, CA). The GC oven temperature was initially set at 215°C, then ramped to 260°C at 1°C/min, and finally increased to 320°C at 15°C/min and held for 1 min. The carrier gas was helium at a column head pressure of 210.3 kPa (column flow: 1.0 mL/min at oven temperature of 215°C). For quantitative analysis, the characteristic ions of each steroid were determined as their TMS derivatives. Peak identifications were achieved by comparing the retention times and matching the height ratios of the characteristic ions [17].

Statistical analysis

The levels of urinary steroids are reported as the mean ± SD. The significance of these variables obtained from the controls and PTC groups was examined using a Student's t-test. The variables in PTC were normalized to the mean of the corresponding controls, and significance of the normalized three groups was also evaluated by one-way variance analysis (one-way ANOVA). A P-value < 0.01 was considered significant. Partial least squares-discrimination analysis (PLS-DA) with multivariate data analysis software SIMCA-P (version 11.0, Umetrics Inc., Sweden) was used for clustering the study groups.

Multivariate data analysis

The processed data was stored in either Excel spreadsheets or Comma Separated Values (CSV) formatted files and then imported into SIMCA software. The urinary steroid levels were classified by PLS-DA for pre- and post-menopausal female and male PTC patients after normalization. PLS-DA maximizes the covariance between the predicting data set, which is X of the numerical value of the targeted steroids, and Y of the class assignment.

The fraction of the variation in the Y variables "explained" by the selected components (R2Y), along with the fraction of the variation of Y's that can be "predicted" by a component according to cross validation (Q2Y) were calculated to plot and validate the model. After calculating the components for the PLS-DA scatter plot, the significant components were selected according to the rule embedded in SIMCA-P software, whereby Q2 should be larger than zero for more than 100 observations and 0.05 for ≤ 100 observations. The PLS-DA plots were then displayed as the superposition of the highest two latent variables (t[1]/t[2] or p[1]/p[2] as X-, Y- axes), such that most of the association with dummy Y variables could be explained by the variations in X. In addition, the high coefficient values of R2Y and Q2Y revealed good discrimination. In this study, the urinary steroids were scaled and centered prior to PLS-DA. One point in the scatter plot represents the rates of steroid secretion. The metabolic patterns can be interpreted using visual images or the R2Y and Q2Y values.

Results

Urinary levels of steroids in PTC patients

The urinary levels of 84 steroids in the pre- and post-menopausal women and men with PTC, along with their corresponding controls were profiled quantitatively. Tables 1, 2 and 3 list the concentrations in the three PTC groups and their individual controls. In pre-menopausal PTC women, all estrogens including estrone (P < 0.008), 17β-estradiol (P < 0.008), 2-hydroxy-17β-estradiol (P < 0.002), 4-hydroxy-17β-estradiol (P < 0.0003), 17-epiestriol (P < 0.003), 2-hydroxyestriol (P < 0.002) were increased, whereas 2-hydroxyestrone was significantly decreased (P < 0.007). All androgens were also up-regulated in the PTC patients including the most active androgens, dihydrotestosterone (P < 0.005), androstenediol (P < 0.0002), and 16α-hydroxy DHEA (P < 0.0002). Progestins tended to be higher in the PTC patients, but the 5α-dihydroprogesterone levels were slightly lower (P < 0.04). Both corticoids and sterols were not significant (Table 1), whereas lanosterol was detectable in only one patient.
Table 2

Concentrations of urinary steroids in post-menopausal PTC women and control

Steroids

Concentrationa (mean ± SD)

P-value

 

Controls

(n = 16)

PTC

(n = 19)

Controls : PTC

Androgens

   

Dihydrotestosterone

71.99 ± 45.10

91.87 ± 57.97

NSb

Epidihydrotestosterone

38.16 ± 27.60

32.35 ± 58.50

NS

Dehydroepiandrosterone

165.46 ± 91.64

194.37 ± 109.70

NS

Testosterone

102.07 ± 64.62

196.74 ± 232.37

NS

Epitestosterone

92.02 ± 69.39

91.08 ± 60.77

NSb

5α-androstan-3α,17β-diol

87.09 ± 64.60

112.99 ± 94.87

NS

5α-androstan-3β,17β-diol

4.26 (1)

NDc

NCd

5β-androstan-3α,17β-diol

99.98 ± 74.50

109.73 ± 90.40

NS

5β-androstan-3α,17α-diol

67.53 ± 62.11

61.33 ± 68.37

NS

5β-androstan-3β,17α-diol

14.33 ± 13.01 (2)

9.58 ± 7.20 (4)

NC

5α-androstan-3β,17α-diol

22.27 ± 20.57 (2)

34.51 ± 28.74 (4)

NC

5α-androstan-3α,17α-diol

43.24 ± 52.23

37.50 ± 24.00

NS

5β-androstan-3β,17β-diol

ND

18.10 (1)

NC

Androstenedione

110.21 ± 88.05

112.78 ± 59.83

NS

Androstenediol

54.27 ± 26.28

61.30 ± 13.63

NS

Androsterone

4464.11 ± 1786.06

14974.73 ± 17229.72

< 0.02

Etiocholanolone

4850.22 ± 2075.09

13920.59 ± 15821.56

< 0.03

11-keto-androsterone +

11-keto-etiocholanolone

580.33 ± 297.69

1727.55 ± 2045.94

< 0.03

11β-hydroxyandrosterone

4499.84 ± 2455.83

5488.85 ± 4203.96

NS

11β-hydroxyetiocholanolone

1462.44 ± 1071.41

2629.38 ± 2439.84

NS

5β-dihydrotestosterone

4.79 ± 1.61

21.03 ± 9.54

< 0.00003

16α-hydroxy-DHEA

228.48 ± 172.71

271.17 ± 127.46

NS

Epiandrosterone

60.19 ± 61.75

70.25 ± 35.51

NS

5α-Androstanedione

72.20 ± 83.17 (4)

60.13 ± 24.16 (13)

NC

Estrogens

   

Estrone

163.00 ± 176.41 (6)

63.72 ± 47.10 (17)

NC

17β-estradiol

14.24 ± 14.24 (4)

21.84 ± 19.84 (7)

NC

Estriol

56.96 ± 65.77 (6)

60.11 ± 57.72 (17)

NC

2-hydroxyestrone

306.99 ± 99.92 (5)

50.92 ± 30.20 (18)

NC

2-hydroxy-17β-estradiol

131.39 ± 166.91 (6)

168.07 ± 372.40 (17)

NC

4-hydroxyestrone

76.21 ± 15.24 (4)

42.27 ± 49.44 (15)

NC

4-hydroxy-17β-estradiol

33.90 ± 13.10 (4)

44.94 ± 23.08 (16)

NC

2-methoxyestrone

69.67 ± 77.40 (6)

101.47 ± 68.85 (7)

NC

2-methoxy-17β-estradiol

24.53 ± 11.18 (3)

60.09 ± 29.12 (7)

NC

4-methoxyestrone

32.32 (1)

85.60 ± 41.64 (15)

NC

4-methoxy-17β-estradiol

66.69 ± 75.09 (4)

55.39 ± 11.16 (4)

NC

17-epiestriol

254.59 (1)

94.42 ± 44.07 (8)

NC

16-epiestriol

74.15 ± 85.83 (6)

119.59 ± 63.08 (6)

NC

17α-estradiol

ND

ND

NC

2-hydroxyestriol

ND

90.89 ± 102.52 (5)

NC

16-keto-17β-estradiol +

16α-hydroxyestrone

28.01 ± 33.72 (6)

46.10 ± 24.21 (18)

NC

Corticoids

   

Cortisol

235.02 ± 205.57

561.28 ± 345.19

NS

Allodihydrocortisol

71.42 ± 64.96

61.67 ± 84.03

NS

Corticosterone

20.74 ± 5.63

100.83 ± 85.62

< 0.02

Allodihydrocorticosterone

53.16 ± 46.48

66.19 ± 38.41

NS

Dihydrodeoxycorticosterone

20.41 ± 15.52

162.62 ± 155.03

< 0.02

11-deoxycorticosterone

101.66 ± 97.56

61.76 ± 29.06

NS

11-deoxycortisol

101.54 ± 102.04

45.92 ± 22.60

NS

Cortisone

980.80 ± 750.48

2205.39 ± 2667.76

NS

Allotetrahydrocortisol

9613.87 ± 6293.12

17105.92 ± 16369.40

NS

21-deoxycortisol

86.96 ± 32.86

97.31 ± 54.06

NS

11-dehydrocorticosterone

124.14 ± 75.34

194.61 ± 298.04

NS

Tetrahydrodeoxycortisol

794.79 ± 305.00

818.38 ± 581.02

NS

Tetrahydrocortisone

17811.52 ± 12271.25

16114.72 ± 12222.84

NS

Tetrahydrocortisol

8640.16 ± 4558.83

16040.33 ± 12750.63

< 0.05

Tetrahydrodeoxycorticosterone

56.16 ± 73.09

43.58 ± 61.64

NS

Tetrahydrocorticosterone

389.66 ± 207.67

780.31 ± 575.27

< 0.02

11-dehydrotetrahydrocorticosterone

877.74 ± 538.13

1445.62 ± 1602.49

NS

α-cortolone

4888.98 ± 2535.86

29149.71 ± 97516.67

NS

β-cortolone

2589.95 ± 927.40

5524.05 ± 11016.02

NS

20α-dihydrocortisone

375.30 ± 192.08

1766.88 ± 5192.38

NS

α-cortol

944.46 ± 362.03

5294.32 ± 17534.68

NS

β-cortol

2299.34 ± 908.51

8550.42 ± 23540.39

NS

20α-dihydrocortisol

172.51 ± 127.47

786.04 ± 2141.06

NS

Progestins

   

Pregnenolone

66.45 ± 68.65

108.91 ± 65.30

NS

Progesterone

ND

47.86 (1)

NC

5β-dihydroprogesterone

13.35 ± 9.78

ND

NC

5α-dihydroprogesterone

38.87 ± 28.09 (2)

24.96 ± 37.35

NC

20α-hydroprogesterone

121.40 ± 105.37 (3)

276.33 ± 450.77

NC

Epipregnanolone

63.07 ± 63.10

37.64 ± 22.54

NS

Pregnanolone

652.71 ± 1018.03

489.54 ± 1157.06

NS

Allopregnanolone

147.26 ± 129.01

109.29 ± 187.61

NS

Isopregnanolone

60.44 ± 5.17 (3)

73.12 ± 43.22

NC

Pregnanediol

6959.54 ± 12541.46

3635.06 ± 9400.59

NS

Pregnanetriol

1559.68 ± 1314.30

2612.22 ± 3133.33

NS

17α-hydroxypregnenolone

85.37 ± 85.75

106.24 ± 57.67

NS

17α-hydroxyprogesterone

ND

133.63 ± 84.38

NC

11β-hydroxyprogesterone

1204.77 ± 516.99

6580.30 ± 17763.59

NS

Sterols

   

Cholesterol

5103.58 ± 3075.92 (6)

5002.90 ± 3033.29

NC

Desmosterol

197.65 ± 67.86 (2)

ND

NC

Lanosterol

102.03 ± 125.18 (4)

32.83 ± 20.51 (3)

NC

20α-hydroxycholesterol

ND

86.56 ± 4.77 (2)

NC

24S-hydroxycholesterol

116.58 ± 101.37 (4)

54.63 ± 26.17 (7)

NC

The number in the parentheses is the number of subject detected corresponding steroid.

aConcentrations are expressed as ng/g of creatinine (mean ± SD).

bNS, not significant.

cND, not detected.

dNC, not comparable.

Table 3

Concentrations of urinary steroids in the PTC men and control

Steroids

Concentrationa (mean ± SD)

P-value

 

Controls

(n = 20)

PTC

(n = 16)

Controls : PTC

Androgens

   

Dihydrotestosterone

91.39 ± 62.43

132.14 ± 92.41

NSb

Epidihydrotestosterone

20.74 ± 16.54

28.45 ± 14.21

NS

Dehydroepiandrosterone

144.93 ± 58.60

180.74 ± 85.79

NS

Testosterone

101.16 ± 89.00

271.30 ± 270.50

NS

Epitestosterone

181.57 ± 93.89

177.67 ± 111.44

NS

5α-androstan-3α,17β-diol

381.95 ± 183.28

320.57 ± 198.42

NS

5α-androstan-3β,17β-diol

3.70 ± 3.66

83.37 ± 99.92

NS

5β-androstan-3α,17β-diol

432.61 ± 362.77

607.93 ± 1056.85

NS

5β-androstan-3α,17α-diol

55.09 ± 46.59

109.91 ± 153.06

NS

5β-androstan-3β,17α-diol

NDc

4.92 (1)

NCd

5α-androstan-3β,17α-diol

31.72 ± 39.33

54.92 ± 80.93

NS

5α-androstan-3α,17α-diol

31.13 ± 28.59

40.00 ± 63.40

NS

5β-androstan-3β,17β-diol

2.51 (1)

ND

NC

Androstenedione

40.66 ± 21.23

92.10 ± 51.74

< 0.002

Androstenediol

28.68 ± 12.20

82.31 ± 38.09

< 0.00005

Androsterone

10087.69 ± 4603.39

26110.67 ± 11663.35

< 0.00006

Etiocholanolone

8256.47 ± 3997.97

24745.49 ± 16868.98

< 0.002

11-keto-androsterone +

11-keto-etiocholanolone

531.90 ± 598.85

1660.94 ± 1191.92

< 0.003

11β-hydroxyandrosterone

4009.02 ± 2754.69

7037.26 ± 4372.55

< 0.02

11β-hydroxyetiocholanolone

1295.60 ± 1325.27

2087.71 ± 1610.32

NS

5β-dihydrotestosterone

3.01 ± 1.85

17.67 ± 20.67

< 0.02

16α-hydroxy-DHEA

79.37 ± 43.01

186.33 ± 63.29

< 0.000005

Epiandrosterone

24.21 ± 10.91

46.90 ± 33.66

< 0.02

5α-Androstanedione

11.29 (1)

24.39 (1)

NC

Estrogens

   

Estrone

39.69 ± 12.89

60.18 ± 29.20

< 0.02

17β-estradiol

12.91 ± 12.56

15.05 ± 10.68

NS

Estriol

24.62 ± 11.84

44.79 ± 31.46

< 0.03

2-hydroxyestrone

50.27 ± 25.50

91.83 ± 55.12

< 0.02

2-hydroxy-17β-estradiol

195.56 ± 113.59

64.98 ± 38.05

< 0.00007

4-hydroxyestrone

51.38 ± 26.59

59.70 ± 24.78

NS

4-hydroxy-17β-estradiol

18.29 ± 7.63

42.05 ± 13.14

< 0.00009

2-methoxyestrone

22.78 ± 13.07

42.46 ± 20.94

< 0.006

2-methoxy-17β-estradiol

19.41 ± 9.13

27.37 ± 14.25

NS

4-methoxyestrone

17.78 ± 7.24

34.29 ± 16.50

< 0.003

4-methoxy-17β-estradiol

19.00 ± 9.90

28.78 ± 11.78

< 0.03

17-epiestriol

42.81 (1)

49.14 ± 5.76 (2)

NC

16-epiestriol

28.28 ± 19.49

34.70 ± 16.18

NS

17α-estradiol

0.92 (1)

ND

NC

2-hydroxyestriol

0.57 ± 0.77

40.82 ± 69.05

NS

16-keto-17β-estradiol +

16α-hydroxyestrone

9.99 ± 4.63

22.93 ± 10.98

< 0.0003

Corticoids

   

Cortisol

183.91 ± 160.81

487.21 ± 482.28

< 0.03

Allodihydrocortisol

38.21 ± 28.01

17.59 ± 8.64

< 0.005

Corticosterone

33.47 ± 32.89

56.57 ± 91.42

NS

Allodihydrocorticosterone

22.53 ± 10.10

29.87 ± 13.54

NS

Dihydrodeoxycorticosterone

32.30 ± 37.87

134.38 ± 105.38

< 0.02

11-deoxycorticosterone

28.74 ± 15.27

28.78 ± 13.55

NS

11-deoxycortisol

37.14 ± 16.35

32.66 ± 15.58

NS

Cortisone

511.43 ± 377.83

1580.13 ± 1320.58

< 0.006

Allotetrahydrocortisol

9510.49 ± 4735.51

20666.67 ± 12334.24

< 0.003

21-deoxycortisol

63.27 ± 29.68

88.63 ± 45.03

NS

11-dehydrocorticosterone

110.59 ± 105.33

148.87 ± 147.64

NS

Tetrahydrodeoxycortisol

405.48 ± 214.37

756.82 ± 539.85

< 0.03

Tetrahydrocortisone

11055.45 ± 5289.49

18809.78 ± 11894.93

< 0.03

Tetrahydrocortisol

6091.23 ± 2812.78

16371.31 ± 10629.87

< 0.002

Tetrahydrodeoxycorticosterone

24.76 ± 15.31

37.50 ± 24.52

NS

Tetrahydrocorticosterone

433.03 ± 604.84

659.73 ± 380.95

NS

11-dehydrotetrahydrocorticosterone

993.99 ± 1013.47

1127.02 ± 618.49

NS

α-cortolone

4030.85 ± 1778.81

6992.04 ± 3748.34

< 0.009

β-cortolone

2284.12 ± 1041.75

3306.24 ± 1662.55

< 0.05

20α-dihydrocortisone

252.58 ± 107.63

431.88 ± 202.66

< 0.005

α-cortol

838.32 ± 319.86

1180.62 ± 550.93

< 0.04

β-cortol

2181.33 ± 886.33

3316.76 ± 1830.36

< 0.04

20α-dihydrocortisol

87.90 ± 57.63

188.16 ± 129.88

< 0.01

Progestins

   

Pregnenolone

27.08 ± 13.26

41.82 ± 15.30

< 0.02

Progesterone

22.47 ± 11.45 (2)

47.85 ± 10.86 (3)

NC

5β-dihydroprogesterone

7.90 ± 7.77

11.18

NS

5α-dihydroprogesterone

24.37 ± 11.29

28.45 ± 35.05

NS

20α-hydroprogesterone

35.96 ± 24.53

76.35 ± 54.00

< 0.01

Epipregnanolone

13.87 ± 8.23

16.85 ± 6.83

NS

Pregnanolone

251.57 ± 121.38

559.35 ± 835.31

NS

Allopregnanolone

55.53 ± 25.97

92.13 ± 129.62

NS

Isopregnanolone

32.57 ± 11.39

47.07 ± 24.81

NS

Pregnanediol

1896.17 ± 1077.27

5669.51 ± 10408.32

NS

Pregnanetriol

2704.00 ± 1146.97

3975.05 ± 1957.07

< 0.04

17α-hydroxypregnenolone

39.84 ± 22.13

58.70 ± 38.95

NS

17α-hydroxyprogesterone

15.19 (1)

39.82 ± 19.99

NC

11β-hydroxyprogesterone

818.94 ± 373.38

2518.86 ± 1739.51

< 0.002

Sterols

   

Cholesterol

2028.74 ± 1781.46

3851.26 ± 2743.30

< 0.04

Desmosterol

216.36 ± 88.55

421.52 ± 622.80

NS

Lanosterol

58.32 ± 73.89

43.89 ± 30.30

NS

20α-hydroxycholesterol

49.98 (1)

85.15 (1)

NC

24S-hydroxycholesterol

111.65 ± 207.00

27.96 ± 15.91

NS

The number in the parentheses is the number of subject detected corresponding steroid.

aConcentrations are expressed as ng/g of creatinine (mean ± SD).

bNS, not significant.

cND, not detected.

dNC, not comparable.

In contrast, the levels of corticosterone (P < 0.02), dihydrodeoxycorticosterone (P < 0.02), tetrahydrocortisol (P < 0.05) and tetrahydrocorticosterone (P < 0.02) were slightly higher in the post-menopausal PTC women than in the corresponding controls (Table 2). Most estrogens could be up-regulated in the groups studied but their urinary levels were undetectable in many post-menopausal women in both the patient and control groups. The levels of 5β-dihydrotestosterone were significantly higher in the patient group (P < 0.00003), but this was not clinically meaningful. The other steroids, progestins and sterols were not significant.

In PTC men, the 4-hydroxy-17β-estradiol (P < 0.00009), 2-methoxyestrone (P < 0.006) and 4-methoxyestrone (P < 0.003) levels were significantly higher in the patients, whereas 2-hydroxy-17β-estradiol levels were lower (P < 0.00007; Table 3). In particular, increased levels of 2-hydroxyestrone and decreased levels of 2-hydroxy-17β-estradiol in the patients were reversible with the results obtained from the PTC women. Although the corticoids levels in the pre- and post-menopausal women groups were not associated with PTC, the levels of most corticoids were higher the patients except for allodihydrocortisol (38.21 ± 28.01 ng/g creatinine for controls; 17.59 ± 8.64 for patients, P < 0.005). Some active androgens including androstenedione (P < 0.002), androstenediol (P < 0.00005) and 16α-hydroxy-DHEA (P < 0.000005) in the patients were associated with PTC. The levels of progestins and sterols were not remarkable.

In all cases, androgens were up-regulated in the patient groups compared to the control groups. Among the urinary androgens studied, five androgens (androsterone, etiocholanolone, 11-keto-androsterone, 11-keto-etiocholanolone and 5β-DHT), which are abundant steroids in humans, were significantly higher in all patient groups (Tables 1, 2, and 3). Active androgens including androstenedione, androstenediol and 16α-hydroxy DHEA were significantly higher in the pre-menopausal women and men with PTC, but not in the post-menopausal PTC women. Estrogens were also up-regulated in all patients compared to the controls. In particular, the 2-hydroxyestrone level was lower in the pre-menopausal PTC women (P < 0.007) but higher in the PTC men (P < 0.02). In contrast, 2-hydroxy-17β-estradiol was higher in the pre-menopausal PTC women (P < 0.002), whereas its level was lower in PTC men (P < 0.00007). Two hydroxylated estrogens at C-2 showed different biological actions between genders. Corticoids were slightly higher in the PTC men and post-menopausal PTC women but not in pre-menopausal PTC women. Progestins were also higher in the patients except for post-menopausal PTC women. In this study, no sterols were shown to be significant in the PTC groups.

Group differences in the steroid metabolism

To exclude the nature of menopause and gender differences between the patient groups studied, all steroid levels in the PTC groups were normalized to the mean values of the corresponding controls, and the different pathogenesis of PTC was then compared according to the menopausal and gender conditions. Statistical analysis was performed using PLS-DA with normalized levels of steroids in the three groups (Additional file. 1). Using the visual inspecting metabolic patterns of steroids and the coincidences between R2Y and Q2Y, the pre- and post-menopausal women, and male groups with PTC were clustered individually (Additional file 1A). Their metabolic patterns were discriminated clearly (R2Y = 0.727, Q2Y = 0.558). The loading plot of PLS-DA, which is complement to the score plot due to the transposed matrix calculation, was also performed to identify the possible urinary biomarkers. Each data point represents one particular steroid with the relationship between the different PTC patients (Additional file 1B). The metabolic differentiation between the groups complemented the results listed in Additional file 2.

Several possible biomarkers for individual PTC groups were selected (Additional file 2). The levels of androstenediol (P < 0.005) was significantly higher in the PTC men than in both PTC women groups, whereas 16α-hydroxy DHEA was higher in both pre-menopausal and men with PTC (P < 0.002). The normalized androgens levels in PTC men were significantly higher than normalized pre- or post-menopausal PTC women (androstenediol, P < 0.005; 16α-hydroxy-DHEA, P < 0.002) (Additional file 2). In both PTC women groups, corticosterone (P < 0.005) and dihydrodeoxycorticosterone (P < 0.009) were higher in the post-menopausal PTC women group than in the pre-menopausal PTC women and PTC men, whereas the post-menopausal PTC women showed lower levels of 11-deoxycorticosterone (P < 0.003). The normalized corticoids levels (corticosterone, P < 0.005; dihydrodeoxycorticosterone, P < 0.009; 11-deoxycorticosterone, P < 0.003) of post-menopausal PTC women were significantly higher than in the other groups (Additional file 2). In progestins, only epipregnanolone showed a significance in post-menopausal PTC women compared to both pre-menopausal and men with PTC (P < 0.0004). In the case of 24S-hydroxycholesterol, its urinary concentrations were not remarkable in any of the groups compared, but the normalized values were significantly higher in the pre-menopausal PTC women (P < 0.000002). Estrogens (estrone, P < 0.0001, 2-hydroxy-17β-estradiol, P < 0.002; 4-hydroxyestrone, P < 0.001; 4-hydroxy-17β-estradiol, P < 0.006; 17-epiestriol, P < 0.0008) in the pre-menopausal PTC women were significantly higher than those of post-menopausal women and men with PTC, whereas 2-hydroxyestrone was significantly higher in PTC men (P < 0.0000001).

To demonstrate the enzyme activities in the steroid metabolism, the ratio of the steroid metabolite to precursor was examined. Box plots of the altered steroids normalized in all PTC patients showed differences in these ratios (Figure 1). The 16α-hydroxylation of DHEA was differentiated between pre-menopausal women and men with PTC (Figure 1A). In the case of 2-hydroxylation, all PTC groups were significantly discriminated with the 2-hydroxyestrone to estrone ratio (Figure 1B), whereas the 2-hydroxy-17β-estradiol to 17β-estradiol ratio could differentiate the pre-menopausal PTC women with post-menopausal PTC women and PTC men (Figure 1C). For 2-methoxylation, all groups were differentiated with the ratio of 2-methoxyestrone to 2-hydroxyestrone (Figure 1D), whereas 17β-estradiol represented the pre-menopausal women and men with PTC groups (Figure 1E). 4-methoxylation with the 4-methoxyestrone to 4-hydroxyestrone ratio showed differences between post-menopausal PTC women and the other two PTC groups (Figure 1F), whereas 4-hydroxy-17β-estradiol differentiated between pre-menopausal women and men with PTC (Figure 1G). There were statistically significant differences found in the estrogen metabolites ratio of 2-hydroxyestrone to 2-hydroxy-17β-estradiol, which could indicate 17β-hydroxysteroid dehydrogenase (17β-HSD) between women and men with PTC (< 4 × 10-7; Figure 2).
https://static-content.springer.com/image/art%3A10.1186%2F1471-2407-11-342/MediaObjects/12885_2011_Article_2827_Fig1_HTML.jpg
Figure 1

Enzyme activities based on the normalized levels of urinary steroids from pre- and post-menopausal women and men with PTC. The level differences significant at the P < 0.01 were selected. Line within the box represents the median, lower boundary of the box indicates 25%, and the upper boundary of the box indicates 75%. Whiskers above and below indicate the maximum and minimum steroid levels. Dots above and below indicate the plot outliers with the 10th and 90th percentiles.

https://static-content.springer.com/image/art%3A10.1186%2F1471-2407-11-342/MediaObjects/12885_2011_Article_2827_Fig2_HTML.jpg
Figure 2

Altered 2-hydroxyestrone to 2-hydroxy-17β-estradiol metabolic ratio in sex difference. Its metabolic ratio could reveal 17β-hydroxysteroid dehydrogenase in the estrogen metabolism. Line within the box represents the median, lower boundary of the box indicates 25%, and the upper boundary of the box indicates 75%. Whiskers above and below indicate the maximum and minimum steroid levels. Dots above and below indicate the plot outliers with the 10th and 90th percentiles.

Discussion

Although an understanding of the pathogenesis and development in PTC has been investigated, there is no data available on the metabolic alteration of steroids according to gender and menopausal condition. The metabolic profiling of urinary steroids in pre- and post-menopausal women, and men with PTC were achieved. Due to gender and menopausal variations in steroid biosynthesis, each patient group was normalized to the corresponding control group before comparing the patient groups.

ERα causes cell proliferation and progress in PTC [7, 12, 19]. The level of ERα is higher in PTC cells than normal cells, and is higher in pre-menopausal women than in both post-menopausal women and men with PTC [7]. The urinary levels of estrogens in pre-menopausal women were investigated first. The concentrations of all estrogens in the pre-menopausal PTC women were higher than the controls, except for 2-hydroxyestrone, which was significantly lower (Table 1). The extent to which the 2-hydroxyestrogens are active or can form active or genotoxic metabolites is controversial [20, 21]. 2-hydroxyestrone has been characterized as the "good estrogen" [22]. In addition, the normalized levels of estrone, 2-hydroxy-17β-estradiol, 4-hydroxyestrone, and 4-hydroxy-17β-estradiol were also significantly higher in pre-menopausal PTC women than normalized post-menopausal women and men with PTC, whereas the level of 2-hydroxyestrone was significantly up-regulated in PTC men (Additional file 2). In addition, the estrogen metabolism has been shown to potentiate the growth of hormone related cancers, such as breast and cervical cancer [23, 24]. 2-Hydroxyestrone and 16α-hydroxyestrone as the oxidative metabolites of estrone have different biological actions with anti-proliferation and proliferative effects, respectively, in hormone related cancers [24, 25].

In this study, 16α-hydroxyestrone was not exactly quantified because of its co-elution with 16-keto-17β-estradiol during chromatographic separation. In addition, 4-hydroxyestrone generates reactive oxygen species (ROS) as a source of oxidative stress through estrogen metabolic redox cycling [26] and increases the formation of endogenous carcinogens [24]. Here, 4-hydroxyestrogens was increased significantly, whereas 2-hydroxyestrone was decreased in both PTC women groups (Tables 1, 2 and 3). In general, 2-hydroxyestrone does not have estrogenic activity peripherally and may be anti-estrogenic, leading to an anti-proliferative effect on estrogen-sensitive cells as the good estrogen [27].

AR causes cell proliferation in PTC [15] and its activity is higher in men than women, and is more active in PTC cells than normal cells [1416]. Nevertheless, the concentrations of most estrogens, except for 2-hydroxy-17β-estradiol, and androgens (androstenedione, androstenediol, androsterone, etiocholanolone, and 16α-hydroxy-DHEA) in PTC men were higher than the controls (Table 3). The normalized levels of androstenediol and 16α-hydroxy-DHEA in PTC men were significantly higher than normalized pre- or post-menopausal PTC women through the higher androgen levels in men (Additional file 2). In addition, the levels of AR were increased by a testosterone treatment in PTC [28]. In this study, the normalized levels of testosterone in PTC men were more significant than pre- or post-menopausal PTC women through AR activation, and the normalized levels of androstenedione and androstenediol as a precursor of testosterone in PTC males were more significant than in the other PTC groups (Additional file 2).

Based on their metabolic actions, corticoids are divided by glucocorticoids and mineralocorticoids, [29] and they are generally considered to simulate lipogenesis, and accelerate fatty acid synthesis [30, 31]. Therefore, the concentrations of both corticoids series, such as corticosterone, dihydrodeoxycorticosterone, tetrahydrocortisol, and tetrahydrocorticosterone in post-menopausal PTC women are higher than its controls (Table 2). However, the normalized levels of mineralocorticoids including corticosterone, dihydrodeoxycorticosterone, and 11-deoxycorticosterone in post-menopausal PTC women were significantly higher than in the other groups (Additional file 2).

Many steroids and metabolic ratios indicate both menopausal and gender differences in PTC progression (Figure 1) but their levels are discriminated by the degree of up-regulation in PTC patients. In particular, 2-hydroxyestrone and 2-hydroxy-17β-estradiol show reversible actions between pre-menopausal women and men with PTC (Tables 1 and 3). 2-hydroxyestrone stimulates the anti-proliferation of cancer cells directly, whereas the effect of 2-hydroxy-17β-estradiol on carcinomas is more complex. In addition, 2-hydroxy-17β-estradiol was up-regulated in the pre-menopausal PTC women and its production may result in oxidative DNA damage and apoptosis in human mammalian cells [32]. Inter-conversion between 2-hydroxyestrone and 2-hydroxy-17β-estradiol catalyzed by 17β -HSD was significantly altered in PTC men against both pre- and post-menopausal women with PTC (Figure 2). The expression of 17β-HSD is not only specific in thyroid disorders [7], but may indicate the gender differences. However, its reversible actions in men have not been investigated.

Conclusions

Although both most androgens and estrogens were increased in the pre-menopausal women with PTC in this study, hydroxylation and methoxylation with estrogens explained more the metabolic changes between all groups studied. In this cross-sectional study, the thyroid cancer risk might be associated with lower 2-hydroxyation activities of either estrone or 17β-estradiol in women and men. Overall, the 2-hydroxyestrone to 2-hydroxy-17β-estradiol metabolic ratio, which indicates the activity of 17β-HSD, may in fact be gender differences in the thyroid cancer progression. These results may help better understand the pathogenesis of PTC according to gender and menopausal conditions.

Declarations

Acknowledgements

This study was supported by an intramural grant from the Korean Institute of Science and Technology, and by the Converging Research Center Program through the Ministry of Education, Science and Technology (2010K001117).

Authors’ Affiliations

(1)
Future Convergence Research Division, Korea Institute of Science and Technology
(2)
Department of Internal Medicine, Yonsei University College of Medicine

References

  1. Correa P, Chen VW: Endocrine gland cancer. Cancer. 1995, 75: 338-352. 10.1002/1097-0142(19950101)75:1+<338::AID-CNCR2820751316>3.0.CO;2-F.View ArticlePubMedGoogle Scholar
  2. Rosenthal DS: Changing trends. CA Cancer J Clin. 1998, 48: 3-23. 10.3322/canjclin.48.1.3.View ArticlePubMedGoogle Scholar
  3. Manole D, Schildknecht B, Gosnell B, Adams E, Derwahl M: Estrogen promotes growth of human thyroid tumor cells by different molecular mechanisms. J Clin Endocrinol Metab. 2001, 86: 1072-1077. 10.1210/jc.86.3.1072.PubMedGoogle Scholar
  4. Sakoda LC, Horn-Ross PL: Reproductive and menstrual history and papillary thyroid cancer risk: the San Francisco Bay area thyroid cancer study. Cancer Epidemiol Biomarks Prev. 2002, 11: 51-57.Google Scholar
  5. Levi F, Franceschi S, Gulie C, Negri E, La Vecchia C: Female thyroid cancer: the roles of reproductive and hormonal factors in Switzerland. Oncology. 1993, 50: 309-315. 10.1159/000227201.View ArticlePubMedGoogle Scholar
  6. Diaz NW, Mazoujian G, Wick MR: Estrogen-receptor protein in thyroid neoplasms: an immunohistochemical analysis of papillary carcinoma, follicular carcinoma, and follicular adenoma. Arch Pathol Lab Med. 1991, 115: 1203-1207.PubMedGoogle Scholar
  7. Kawabata W, Suzuki T, Moriya T, Fujimori K, Nagamura H, Inoue S, Kinouchi Y, Kameyama K, Takami H, Shimosegawa T, Sasano H: Estrogen receptors (α and β) and 17β-hydroxysteroid dehydrogenase type 1 and 2 in thyroid disorder: possible in situ estrogen synthesis and actions. Mod Pathol. 2003, 16: 437-444. 10.1097/01.MP.0000066800.44492.1B.View ArticlePubMedGoogle Scholar
  8. Mori M, Naito M, Watanabe H, Takeichi N, Dohi K, Ito A: Effects of sex difference, gonadectomy and estrogen on N-methyl-N-nitrosourea induced rat thyroid tumors. Cancer Res. 1990, 50: 7662-7667.PubMedGoogle Scholar
  9. Negri E, Dal Maso L, Ron E, La Vecchia C, Mark SD, Preston-Martin S, McTiernan A, Kolonel L, Yoshimoto Y, Jin F, Wingren G, Rosaria Galanti M, Hardell L, Glattre E, Lund E, Levi F, Linos D, Braga C, Franceschi S: A pooled analysis of case-control studies of tyroid cancer II. Menstrual and reproductive factors. Cancer Causes Control. 1999, 10: 143-155. 10.1023/A:1008880429862.View ArticlePubMedGoogle Scholar
  10. La Vecchia C, Ron E, Franceschi S, Dal Maso L, Mark SD, Chatenoud L, Braga C, Preston-Martin S, McTiernan A, Kolonel L, Mabuchi K, Jin F, Wingren G, Galanti MR, Hallquist A, Lund E, Leve F, Linos D, Negri E: A pooled analysis of case-control studies of tyroid cancer III. Oral contraceptives, menopausal replacement therapy and other female hormones. Cancer Causes Control. 1999, 10: 157-166. 10.1023/A:1008832513932.View ArticlePubMedGoogle Scholar
  11. Segey DL, Umbricht C, Zeiger MA: Molecular pathogenesis of thyroid cancer. Surg Oncol. 2003, 12: 69-90. 10.1016/S0960-7404(03)00037-9.View ArticleGoogle Scholar
  12. Zeng Q, Chen GG, Vlantis AC, Tse GM, Hasselt CA: The contributions of oestrogen receptor isoforms to the development of papillary and anaplastic thyroid carcinomas. J Pathol. 2008, 214: 425-433.View ArticlePubMedGoogle Scholar
  13. Prinz RA, Sandberg L, Chaudhuri PK: Androgen receptors in human thyroid tissue. Surgery. 1984, 96: 996-1000.PubMedGoogle Scholar
  14. Rossi R, Franceschetti P, Maestri I, Magri E, Cavazzini L, degli Uberti EC, del Senno L: Evidence for androgen receptor gene expression in human thyroid cells and tumours. J Endocrinol. 1996, 148: 77-85. 10.1677/joe.0.1480077.View ArticlePubMedGoogle Scholar
  15. Marugo M, Torre G, Bernasconi D, Fazzuoli L, Cassulo S, Giordano G: Androgen receptors in normal and pathological thyroids. J Endocrinol Invest. 1991, 14: 31-35.View ArticlePubMedGoogle Scholar
  16. Miki H, Oshimo K, Inoue H, Morimoto T, Monden Y: Sex hormone receptors in human thyroid tissues. Cancer. 1990, 66: 1759-1762. 10.1002/1097-0142(19901015)66:8<1759::AID-CNCR2820660820>3.0.CO;2-X.View ArticlePubMedGoogle Scholar
  17. Moon JY, Jung HJ, Moon MH, Chung BC, Choi MH: Heat-map visualization of gas chromatography-mass spectrometry based quantitative signatures on steroid metabolism. J Am Soc Mass Spectrom. 2009, 20: 1626-1637. 10.1016/j.jasms.2009.04.020.View ArticlePubMedGoogle Scholar
  18. Husdan H, Rapoport A: Estimation of creatinine by the Jaffe reaction. A comparison of three methods. Clin Chem. 1968, 14: 222-238.PubMedGoogle Scholar
  19. Zeng Q, Chen GG, Vlantis AC, Hasselt CA: Oestrogen mediates the growth of human thyroid carcinoma cells via an oestrogen receptor - ERK pathway. Cell Prolif. 2007, 40: 921-935. 10.1111/j.1365-2184.2007.00471.x.View ArticlePubMedGoogle Scholar
  20. Martucci C, Fishman J: Direction of estradiol metabolism as a control of its hormonal action-uterotrophic activity of estradiol metabolites. Endocrinology. 1977, 101: 1709-1715. 10.1210/endo-101-6-1709.View ArticlePubMedGoogle Scholar
  21. Liehr JG, Ulubelen AA, Strobel HW: Cytochrome P-450 mediated redox cycling of estrogens. J Biol Chem. 1986, 261: 16865-16870.PubMedGoogle Scholar
  22. Bradlow HL, Telang NT, Sepkovic DW, Osborne MP: 2-Hydroxyestrone: the "good" estrogen. J Endocrinol. 1996, 150: S259-S265.PubMedGoogle Scholar
  23. Miller DG, Sepkovic DW, Bradlow HL, Martucci CP, Levine BS, Cunningham-Rundles S: The effect of nutritional intervention on immune functions and other biomarkers in high cancer risk individuals. J Nutri Immunol. 1997, 5: 9-15.Google Scholar
  24. Parl FF, Dawling S, Roodi N, Crooke PS: Estrogen metabolism and breast cancer: a risk model. Ann N Y Acad Sci. 2009, 1155: 68-75. 10.1111/j.1749-6632.2008.03676.x.View ArticlePubMedGoogle Scholar
  25. Chan EK, Sepkovic DW, Yoo Bowne HJ, Pei Yu G, Schantz SP: A hormonal association between estrogen metabolism and proliferative thyroid disease. Otolaryngol Head Neck Surg. 2006, 134: 893-900. 10.1016/j.otohns.2006.01.020.View ArticlePubMedGoogle Scholar
  26. Roy D, Liehr JG: Estrogen, DNA damage and mutations. Mutat Res. 1999, 424: 107-115.View ArticlePubMedGoogle Scholar
  27. Swaneck G, Fisman J: Covalent binding of the endogenous estrogen 16-hydroxyestrone to estradiol receptors in human breast cancer cells: characterization and intranuclear localization. Proc Natl Acad Sci USA. 1988, 85: 7831-7835. 10.1073/pnas.85.21.7831.View ArticlePubMedPubMed CentralGoogle Scholar
  28. Banu SK, Govindarajulu P, Aruldhas MM: Testosterone and estradiol up-regulate androgen and estrogen receptors in immature and adult rat thyroid glands in vivo. Steroids. 2002, 67: 1007-1014. 10.1016/S0039-128X(02)00063-6.View ArticlePubMedGoogle Scholar
  29. Cho HJ, Kim JD, Lee W-Y, Chung BC, Choi MH: Quantitative metabolic profiling of 21 endogenous corticosteroids in urine by liquid chromatography-triple quadrupole-mass spectrometry. Anal Chim Acta. 2009, 632: 101-108. 10.1016/j.aca.2008.10.059.View ArticlePubMedGoogle Scholar
  30. Hillgartner FB, Salati LM, Goodridge AG: Physiological and molecular mechanisms involved in nutritional regulation of fatty acid synthesis. Physiol Rev. 1995, 75: 47-76.PubMedGoogle Scholar
  31. Berdanier CD: Role of glucocorticoids in the regulation of lipogenesis. FASEB J. 1989, 3: 2179-2183.PubMedGoogle Scholar
  32. Hurh YJ, Chen ZH, Na HK, Han SY, Suhr YJ: 2-Hydroxyestradiol induces oxidative DNA damage and apoptosis in human mammary epithelial cells. J Toxicol Environ Health A. 2004, 67: 1939-1953. 10.1080/15287390490514598.View ArticlePubMedGoogle Scholar
  33. Pre-publication history

    1. The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2407/11/342/prepub

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