前列腺增生症和前列腺癌的前列腺组织微循环改变

Microcirculation changes in benigh prostatic hyperplasia and prostatic carcinoma

目的探讨前列腺微循环在前列腺病理变化中的作用。方法取前列腺增生症(BPH)未服非那雄胺者标本(简称BPH组)30例和服用非那雄胺标本(简称BPHF)10例,正常前列腺标本(简称NP组)5例,前列腺癌标本(简称PCa组)标本10例,H.E.切片,采用WX-6B型BIU-2000微循环图像处理系统分析间质丽积与腺体面积的比值(S/G),正常腺体与萎缩腺体面积的比值(N/A);CD34免疫组化显示微血管,检测平均微血管密度(MVD)、间质内平均微血管密度(SMVD)、正常腺体微血管密度(NMVD)和萎缩腺体微血管密度(AMVD)。PSA免疫组化测灰度值。分别比较上述各组各指标的差异。结果 BPH组、BPHF及PCa组S/G、MVD高于NP组,BPH、BPHF组N/A和PSA灰度值低于NP组(P<0.01),BPHF与BPH组比较,S/G、N/A及SMVD降低,PSA灰度值升高(PSA表达降低)(P<0.01)。相关分析提示,PSA与S/G和SMVD都呈正相关性。结论前列腺组织内局部微循环与前列腺病理改变密切相关。间质微血管增多可能是前列腺间质增生的原因之一,PSA可通过影响腺体和间质内微循环而发挥刺激增生作用。非那雄胺可通过降低PSA及组织内微循环而发挥抑制前列腺增生的作用。

Objective To investigate the microcirculation changes in the pathological development of prostate diseases. Methods Prostate tissues were respectively collected by transurethral resection of prostate or open prostatectomy from 30 BPH patients untreated with oral finarsteride （BPH group）, 10 BPH patients treated with oral finarsteride （BPHF group）, 5 donators （NP group） and 10 PC patients（PC group）. All samples were sectioned and stained by H.E. The expression of PSA and CD34 were detected by immunohistochemistry. The area of stroma and glandule （normal or atrophied）, specific value of the area of stroma and glandule （S/G）, area of normal glandule and atrophied glandule （N/A）, the mean vessel density （MVD）, MVD in stroma （SMVD）, MVD around normal glandule （NMVD）, MVD around atrophied glandule （AMVD） were measured with the BIU-2000 microcirculation image management system. Results The values of S/G and SMVD in BPH, BPHF and PC groups were higher than those of NP group whereas PSA level was significantly lower than that of NP group. The values of S/G, N/A and SMVD in BPHF group were lower than that of BPH. Expression of PSA decresed in BPHF compared with that of NP group .Correlation analysis showed that level of PSA was positively correlated with value of S/G and SMVD. Conclusion Microcirculation in prostate tissue was significantly correlated with the pathological changes of prostate. Increase of microvessel in stroma might facilitate stromal proliferation. Finaersteride might inhibit prostatic hyperplasia by down-regulation of PSA expression and. tissue microcirculation in prostate.