Background: Benign prostate hyperplasia (BPH) is the most common benign disease of human prostate. Currently BPH is associated with unregulated proliferation of connective tissue and glandular epithelium within the pr...Background: Benign prostate hyperplasia (BPH) is the most common benign disease of human prostate. Currently BPH is associated with unregulated proliferation of connective tissue and glandular epithelium within the prostatic transition zone, and it has been described as relevant characteristic of BPH—the increase of the total number of cells, and not only an increase in cell size. To date, there are few studies on the quantitative morphology of glandular tree of BPH compared with normal prostate. The scarce investigations about this particular suggest that the glandular tree branches and expands as the hyperplastic transformation occurs in the prostate. Methods: To verify if this gland expansion and branching was similar to that occurs in the normal prostate, this study deals with the estimation of several stereological parameters as: labeling index for the proliferating cell nuclear antigen to quantify the rate of proliferation of prostate epithelium, average thickness of glandular epithelium, fraction of the volume occupied by the epithelium relative to the total prostate volume, connectivity density of prostate glands, to quantify the branching of prostate glands, and the average volume and the volume-weighted mean glandular volume of prostate acini to assess the mean size of the prostate acini and its variability. Results: All these estimates have been performed in prostate specific antigen immunostained sections from prostates of young men (controls) and in adenomectomy specimens from the adenofibromiomatous variety of BPH. Conclusion: We conclude that the epithelial proliferation is not the only factor intervening in the development of BPH. In addition, a more prolonged survival of epithelial population, together with some degree of hypertrophy of acini expressed by the increase of volume fraction and thickness of acinar epithelium, is relevant in order to the growth and expansion of the BPH glandular tree that shows more abundant and heterogeneous acinar sprouts than in normal prostate.展开更多
Background: Benign prostate hyperplasia (BPH) is the most common benign disease of the human prostate. The comparison between global versus local changes in spatial patterns of pathological lesions provoked a growing ...Background: Benign prostate hyperplasia (BPH) is the most common benign disease of the human prostate. The comparison between global versus local changes in spatial patterns of pathological lesions provoked a growing interest in some fields such as neuropathology. To date, there is little data on this subject in prostatic pathology. Given the interest of local parameters to distinguish between normal and pathological structures, the present study will apply first and second order stereological tools to find out if the cytokeratin18 (ck18) immunoexpression shows relevant local changes in BPH compared to normal prostate, independently if global estimates were similar in both groups. Methods: To verify if the global and local changes in immuno-expression of ck18 are relevant to ascertain differences between normal (CTR) and BPH cases, the following parameters will be applied: Volume fraction of epithelium immunostained for ck18 (VV ck18), both in global and local estimates;dispersion indices of VV ck18;estimates of local variance of VV ck18 (positional and of scale) using wavelet analysis;and lacunarity analysis to measure the tissue heterogeneity. Then, the set of values from the parameters studied that show significant differences between CTR and BPH will be employed to perform stepwise linear discriminant analyses to determine if locally estimated parameters were able to classify accurately the cases in CTR and BPH groups. Results and Conclusions: The findings of the present study indicate that changes in the expression of ck18 by the hyperplastic prostatic epithelium are not homogeneous. This limits the use of a single biopsy based markers to predict biological behavior in BPH. On the other hand, the local changes in the expression of ck18 are more evident in terms of VV ck18 and its local variability, whereas other parameters that are useful in other pathologies, such as lacunarity, are less relevant In prostatic hyperplasia.展开更多
文摘Background: Benign prostate hyperplasia (BPH) is the most common benign disease of human prostate. Currently BPH is associated with unregulated proliferation of connective tissue and glandular epithelium within the prostatic transition zone, and it has been described as relevant characteristic of BPH—the increase of the total number of cells, and not only an increase in cell size. To date, there are few studies on the quantitative morphology of glandular tree of BPH compared with normal prostate. The scarce investigations about this particular suggest that the glandular tree branches and expands as the hyperplastic transformation occurs in the prostate. Methods: To verify if this gland expansion and branching was similar to that occurs in the normal prostate, this study deals with the estimation of several stereological parameters as: labeling index for the proliferating cell nuclear antigen to quantify the rate of proliferation of prostate epithelium, average thickness of glandular epithelium, fraction of the volume occupied by the epithelium relative to the total prostate volume, connectivity density of prostate glands, to quantify the branching of prostate glands, and the average volume and the volume-weighted mean glandular volume of prostate acini to assess the mean size of the prostate acini and its variability. Results: All these estimates have been performed in prostate specific antigen immunostained sections from prostates of young men (controls) and in adenomectomy specimens from the adenofibromiomatous variety of BPH. Conclusion: We conclude that the epithelial proliferation is not the only factor intervening in the development of BPH. In addition, a more prolonged survival of epithelial population, together with some degree of hypertrophy of acini expressed by the increase of volume fraction and thickness of acinar epithelium, is relevant in order to the growth and expansion of the BPH glandular tree that shows more abundant and heterogeneous acinar sprouts than in normal prostate.
文摘Background: Benign prostate hyperplasia (BPH) is the most common benign disease of the human prostate. The comparison between global versus local changes in spatial patterns of pathological lesions provoked a growing interest in some fields such as neuropathology. To date, there is little data on this subject in prostatic pathology. Given the interest of local parameters to distinguish between normal and pathological structures, the present study will apply first and second order stereological tools to find out if the cytokeratin18 (ck18) immunoexpression shows relevant local changes in BPH compared to normal prostate, independently if global estimates were similar in both groups. Methods: To verify if the global and local changes in immuno-expression of ck18 are relevant to ascertain differences between normal (CTR) and BPH cases, the following parameters will be applied: Volume fraction of epithelium immunostained for ck18 (VV ck18), both in global and local estimates;dispersion indices of VV ck18;estimates of local variance of VV ck18 (positional and of scale) using wavelet analysis;and lacunarity analysis to measure the tissue heterogeneity. Then, the set of values from the parameters studied that show significant differences between CTR and BPH will be employed to perform stepwise linear discriminant analyses to determine if locally estimated parameters were able to classify accurately the cases in CTR and BPH groups. Results and Conclusions: The findings of the present study indicate that changes in the expression of ck18 by the hyperplastic prostatic epithelium are not homogeneous. This limits the use of a single biopsy based markers to predict biological behavior in BPH. On the other hand, the local changes in the expression of ck18 are more evident in terms of VV ck18 and its local variability, whereas other parameters that are useful in other pathologies, such as lacunarity, are less relevant In prostatic hyperplasia.
