正常青年前列腺大体和组织学特征及分泌蛋白表达

Gross and histological features and expression of secretory proteins in normal prostate of young men

目的探讨正常青年前列腺大体形态和组织学特征及前列腺特异性抗原(PSA)、前列腺分泌蛋白94(PSP94)的表达。方法应用组织学和免疫组化染色对4例正常青年前列腺的大体形态、各区的组织学特征和两种主要分泌蛋白的表达进行系统的观察和研究。结果眼观:前列腺被膜在前列腺尖部较厚,体部较薄,底部菲薄,前列腺尖部的腹侧无被膜;前列腺矢状面及经近段尿道的前列腺连续横断面上可显示中央区(CZ)、外周区(PZ)、移行区(TZ)的大致轮廓,位于尿道两侧的TZ是相对清晰的两个独立小叶,冠状面能较好显示CZ和PZ的位置关系,前列腺各区之间未见明显分界线;镜检CZ的腺泡大,腺上皮形成许多复杂的乳头状嵴突入腺腔,细胞拥挤边界不清,胞质较暗,有细小颗粒,核大,苍白且高低不齐,间质较致密,含有多量平滑肌束环状包绕腺泡;PZ腺泡小而圆,细胞均匀分布边界清楚,胞质透明,核小染色深,常靠近基底部,间质疏松,分布着稀疏的平滑肌;TZ的腺泡和上皮形态和PZ相似,但间质致密,由交叉的平滑肌组成。PSP94在PZ腺泡上皮细胞呈强表达,CZ表达不稳定,TZ染色较弱,PSA在前列腺各区的表达强度无明显差别。结论前列腺被膜在前列腺的不同部位厚薄不均且不连续;前列腺的大体切面上各分区之间无截然的解剖分界线;前列腺各区的组织学特征存在不同程度的差异,其分泌蛋白的表达亦有所不同。

Purpose To investigate normal prostatic gross morphology and histological characteristics and to observe the expression of prostate-specific antigen（PSA） and prostate secretory protein 94（PSP94） in healthy young men.Methods Histology and microscopic examination were used to observe gross morphology,histological features of different anatomic zones in 4 normal prostatic specimens of young men,and the expression of the above two major secretory proteins was detected by immunohistochemistry.Results Grossly,prostatic capsule was thick at prostate apex,thin at prostate body and weak in prostate base.There was a defect in the anterior capsule.Sagittal sections and continuous transversal sections across proximal segment of prostatic urethra could better demonstrate the anatomic relationships among central zone（CZ）,peripheral zone（PZ） and transitional zone（TZ）.TZ consisted of two separate lobes on either side of urethra.The location relationship between CZ and PZ was better visualized in a coronal section.Each zone had no distinctive anatomic boundary in gross dissections from each other.Microscopically,CZ consisted of large acini with complex intraluminal ridges and papillary infoldings.The epithelium in CZ was crowded and had unclear border with dense and tiny granular cytoplasm.Nuclei were large,pale and disordered,lying at different levels.The compact stroma was composed of a large amount of smooth muscle bundles surrounding acini.PZ consisted of small round acini.The epithelium was well-distributed and had clear border with pale cytoplasm and small dark basal nuclei,set in a loose stroma with sparse smooth muscle.TZ acini and epithelium were similar to that in PZ,but set in a compacter stroma composed of interlacing smooth muscle bundles.The expression of PSP94 was intensive in acini in PZ,less intensive in TZ,and variable in CZ.There was little difference among different zones in the expression of PSA.Conclusions The thickness of prostatic capsule in different areas is various and discontinuous;each zone has no distinctive anatomic boundary in gross dissections.There are various degrees of differences in both histological features and expression of secretary proteins among different zones in the prostate.