Altered urinary profiles of polyamines and endogenous steroids in patients with benign cervical disease and cervical cancer

The risk of cancer of the cervix is linked with sexual behavior. Although infectious agents, such as human papillomaviruses (HPVs) are implicated, these alone may be insufficient to induce the disease. We investigated the potential role of estrogen, androgen, and polyamine metabolism as co-factors in the development of cervical cancer. We obtained urine samples from patients with benign cervical disease (n=18) and cervical cancer (n=18) and from age-matched normal female subjects (n=25). For 11 polyamine determination, an improved and sensitive gas-chromatographic with nitrogen/phosphorus-detection (GC/NPD) procedure was used. The urinary levels of 25 androgens and corticoids and 16 estrogens were quantitatively determined by gas chromatography-mass spectrometry-selected ion-monitoring (GC/MS/SIM). In the patients with cervical cancer, the ratio of 16α-hydroxy estrone (16α-OH E1)/2-hydroxy estrone (2-OH E1), putrescine (Put)/N1-acetylspermidine (N1-acSpd) and 5β-tetrahydrocortisol (THF)/5α-tetrahydrocortisol (5α-THF) were significantly increased in comparison to the values of the normal controls. These data suggest: (1) an increase of 16α-hydroxylation in estrogen metabolism; (2) the high activity of polyamine oxidase (PAO) in polyamine metabolism; and (3) the low activity of 5α-reductase in androgen metabolism may play a significant role in the development of cervical cancer. Although additional research is necessary, the combination of 16α-OH E1/2-OH E1 and THF/5α-THF may provide a dual marker for the discrimination of benign cervical disease and cervical cancer.