良性前列腺增生间质结节的演化

Evolution of stromal nodules in benign prostatic hyperplasia

目的 :探讨前列腺增生间质结节的演化过程 ,进一步认识前列腺增生病理组织学分类依据。方法 :应用免疫组织化学方法对 5 5个前列腺增生的间质结节做了波形蛋白、肌细胞肌动蛋白、平滑肌肌动蛋白和第Ⅷ因子相关抗原的免疫组化染色。结果 :结合HE切片和免疫组化结果发现前列腺间质结节的早期为幼稚的纤维性结节 ,随着结节内肌纤维母细胞向平滑肌细胞和纤维细胞的双向分化 ,间质结节可继续演化为纤维肌性结节和肌性结节。5 5个结节按免疫组化分类 ,纤维性结节占 42 % ,纤维肌性结节占 5 1% ,肌性结节占 7%。结论 :前列腺早期的纤维性结节随着肌纤维母细胞向平滑肌和纤维细胞的分化而演化为纤维肌性结节和肌性结节 。

Objective: To clarify the evolution of stromal nodules in benign prostatic hyperplasia(BPH) and to search for a better category for pathologic classification of BPH nodules. Methods: The immunohistochemical studies for such antigens as vimentin, muscle actin(HHF35), smooth muscle actin(1A4) and factor Ⅷ related antigen, were undertaken in 55 stromal nodules of BPH. Results: The study showed that the earliest stromal nodules were fibrous, and with the dual differentiation of myofibroblasts toward both smooth muscle cells and fibrous cells, they developed into fibromyomatous nodules and muscular nodules. The results of reclassifying the 55 nodules immunohistochemically were that 23(42%) was fibrous, 28(51%) fibromuscular nodules and 4(7%) muscular. Conclusion: The results suggested that the fibrous nodules of BPH evolved fibromuscular or muscular nodules with the differentiation of myofibroblast cells within the nodules, and these results were helpful to understand the pathogenesis and development of BPH nodules.