Kaya Cevdet, Ozyurek Mustafa, Turkeri Levent N
Department of Urology, Marmara University Medical Faculty Hospital, Istanbul, Turkey.
Int J Urol. 2005 Feb;12(2):194-8. doi: 10.1111/j.1442-2042.2005.01005.x.
A group of anti-androgens with different mechanisms of action and adverse effects have been investigated in patients with gross hematuria related to benign prostate hyperplasia; however, there is not yet any consensus about the standard management of these patients. The present study aims to identify if any one type of the hormonal intervention is superior in terms of the suppression of microvessel formation in the prostate.
A total of 28 mature, healthy male Sprague-Dawley rats (300 +/- 50 g) were used in this study. The rats were randomly assigned to one of four groups (n = 7 per group). The effects of three different hormonal therapies on angiogenesis and microvascularity in rat ventral prostate were compared. Groups 1 and 2 were treated for 28 days with finasteride and bicalutamide, respectively, and rats from Group 3 underwent surgical castration. Following treatment, all rats included in the study underwent dissection of the ventral prostate and immunohistochemical analysis of microvessel density by factor VIII-related antigen.
The mean number of microvessels in the finasteride and bicalutamide groups was 24.5 (+/-8.44 SE) and 27 (+/-9.89 SE) respectively. In contrast, the castration and control groups had microvessel numbers of 12.9 (+/-5.35 SE) and 40.3 (+/-5.03 SE) respectively. Differences were statistically significant between all three treatment groups and the controls (P < 0.005); the number of microvessels in rat prostate tissues of the control group was significantly higher than the treatment groups. Mean microvessel densities in the bicalutamide and finasteride groups were significantly higher than microvessel densities in the castration group (P < 0.005). There was no statistically significant difference between mean microvessel number in rat prostate tissue treated with finasteride or bicalutamide (P > 0.05).
Even though finasteride was not as effective as castration in reducing microvessel number, its effect was equal to that of bicalutamide in terms of suppressing the angiogenesis in prostatic tissue. Based on the findings of the present study, finasteride might offer a viable option in the management of macroscopic hematuria by inhibition of microvessel formation within the prostatic tissue. Further clinical studies are warranted.
针对与良性前列腺增生相关的肉眼血尿患者，已对一组作用机制和不良反应各异的抗雄激素药物进行了研究；然而，对于这些患者的标准治疗方法尚未达成共识。本研究旨在确定在抑制前列腺微血管形成方面，是否有某一种激素干预方法更具优势。
本研究共使用了28只成熟、健康的雄性Sprague-Dawley大鼠（体重300±50克）。将大鼠随机分为四组（每组n = 7）。比较了三种不同激素疗法对大鼠腹侧前列腺血管生成和微血管形成的影响。第1组和第2组分别用非那雄胺和比卡鲁胺治疗28天，第3组大鼠接受手术去势。治疗后，对研究中纳入的所有大鼠进行腹侧前列腺解剖，并通过VIII因子相关抗原对微血管密度进行免疫组化分析。
非那雄胺组和比卡鲁胺组的微血管平均数量分别为24.5（±8.44 SE）和27（±9.89 SE）。相比之下，去势组和对照组的微血管数量分别为12.9（±5.35 SE）和40.3（±5.03 SE）。所有三个治疗组与对照组之间的差异具有统计学意义（P < 0.005）；对照组大鼠前列腺组织中的微血管数量显著高于治疗组。比卡鲁胺组和非那雄胺组的平均微血管密度显著高于去势组（P < 0.005）。用非那雄胺或比卡鲁胺治疗的大鼠前列腺组织中的微血管平均数量之间无统计学显著差异（P > 0.05）。
尽管非那雄胺在减少微血管数量方面不如去势有效，但其在抑制前列腺组织血管生成方面的效果与比卡鲁胺相当。基于本研究结果，非那雄胺可能通过抑制前列腺组织内微血管形成，为肉眼血尿的治疗提供一种可行的选择。有必要进行进一步的临床研究。
