Cohen Ronald J, Garrett Kerryn, Golding Jemma L, Thomas Robert B, McNeal John E
Uropath Pty Ltd Perth and Perth Urology, Western Australia.
Hum Pathol. 2002 Sep;33(9):905-9. doi: 10.1053/hupa.2002.127440.
Preservation of tissues in glutaraldehyde-based fixatives allows identification of prostatic glandular secretions without resorting to immunostaining. This has enabled detailed histological assessment of the entire male urethra and bladder and has confirmed prostatic epithelial cells outside the confines of the prostate gland. Male and female lower urinary tracts are also compared. Three intact bladders and penile urethras from radical surgical specimens, tissue from 10 radical prostatectomies, 12 penile urethral biopsy specimens, and 40 samples of of metaplastic bladder mucosa were evaluated after undergoing glutaraldehyde-based fixation (Solufix, Tissugen, Western Australia). All sections were immunostained for prostate-specific antigen (PSA) and high molecular-weight cytokeratin. Selected formalin-fixed samples also were assessed and stained for androgen receptor status, and 10 female control subjects also were evaluated. Prostatic epithelial cells, as recognized by their content of prostate secretory granules (PSG), were identified in almost all periurethral glands seen along the length of the penile urethra. These "minor prostatic glands" were composed entirely of prostatic cells or, more commonly, mixed prostatic and mucinous epithelium. The penile urethra was lined by transitional epithelium, whereas the prostatic urethra was lined by glandular cells with superficial androgen receptor-positive cells that had lost much of their secretory function. Foci of cystitis cystica/glandularis contained prostatic cells in more than half of the cases evaluated, and in all cases PSG secretion in extraprostatic sites was commensurate with PSA secretion. No prostatic secretion was seen in the female control cases, and the female urethra, in contrast to the male urethra, was lined entirely by glycogenated stratified squamous epithelium similar to the epithelium lining the vagina and vulva. This study defines the entity of minor prostatic glands and confirms their extensive normal distribution in the adult male subject. Minimal but persistently elevated levels of serum PSA occuring after successful radical prostatectomy may be related in part to this phenomenon. The female lower urinary tract differs considerably from the male but has similar features related to the lower genital tract.
使用基于戊二醛的固定剂保存组织，无需免疫染色就能识别前列腺腺分泌。这使得对整个男性尿道和膀胱进行详细的组织学评估成为可能，并证实了前列腺腺体外的前列腺上皮细胞。还对男性和女性下尿路进行了比较。对3个来自根治性手术标本的完整膀胱和阴茎尿道、10例根治性前列腺切除术的组织、12例阴茎尿道活检标本以及40例化生膀胱黏膜样本进行了基于戊二醛的固定（Solufix，Tissugen，西澳大利亚）后进行评估。所有切片均进行前列腺特异性抗原（PSA）和高分子量细胞角蛋白免疫染色。对选定的福尔马林固定样本也进行了雄激素受体状态评估和染色，还评估了10名女性对照受试者。通过前列腺分泌颗粒（PSG）的含量识别出的前列腺上皮细胞，在阴茎尿道全长所见的几乎所有尿道周围腺体中都能找到。这些“小前列腺腺”完全由前列腺细胞组成，或者更常见的是，由前列腺和黏液上皮混合组成。阴茎尿道内衬移行上皮，而前列腺尿道内衬有腺体细胞，其表面雄激素受体阳性细胞已失去大部分分泌功能。在超过一半的评估病例中，囊性膀胱炎/腺性膀胱炎病灶含有前列腺细胞，并且在所有病例中，前列腺外部位的PSG分泌与PSA分泌相当。在女性对照病例中未发现前列腺分泌，与男性尿道不同，女性尿道完全由类似于阴道和外阴内衬上皮的糖原化复层鳞状上皮内衬。这项研究定义了小前列腺腺的实体，并证实了它们在成年男性受试者中的广泛正常分布。根治性前列腺切除术后血清PSA水平持续轻微升高可能部分与此现象有关。女性下尿路与男性有很大不同，但与下生殖道有相似特征。
