Department of Systems and Information Engineering, University of Virginia, Charlottesville, VA 22904, USA.
Med Eng Phys. 2011 Apr;33(3):302-9. doi: 10.1016/j.medengphy.2010.10.013. Epub 2010 Nov 18.
The mechanical characterization of prostate tissue has not received much attention and is often disconnected from the clinic, where samples are readily attained.
We developed a spherical indenter for the clinic to generate force-displacement data from ex vivo prostate tissue. Indentation velocity, depth, and sphere diameter, and four means of estimating elastic modulus (EM) were validated. EM was then estimated for 26 prostate specimens obtained via prostatectomy and 6 samples obtained from autopsy. Prostatectomy prostates were evaluated clinically upon digital rectal exam and pathologically post-extirpation.
Whole-mount measurements yielded median EM of 43.2 kPa (SD=59.8 kPa). Once sliced into cross-sections, median EM for stage T2 and T3 glands were 30.9 and 71.0 kPa, respectively, but not significantly different. Furthermore, we compared within-organ EM difference for prostates with (median=46.5 kPa, SD=22.2 kPa) and without (median=31.0 kPa, SD=63.1 kPa) palpable abnormalities.
This work finds that diseased prostate tissue is stiffer than normal tissue, stiffness increases with disease severity, and large variability exists between samples, even though disease differences within a prostate are detectable. A further study of late-stage cancers would help to strengthen the findings presented in this work.
前列腺组织的力学特性尚未得到太多关注,并且常常与临床脱节,而临床很容易获得样本。
我们开发了一种用于临床的球形压头,可从前列腺组织中获取力-位移数据。验证了压入速度、深度、球体直径和四种估计弹性模量(EM)的方法。然后,对 26 个前列腺切除术标本和 6 个尸检标本进行了 EM 估计。前列腺切除术标本在直肠指检时进行临床评估,并在切除后进行病理评估。
整体测量得到的中位 EM 为 43.2 kPa(SD=59.8 kPa)。一旦切成横截面,T2 和 T3 期腺体的中位 EM 分别为 30.9 和 71.0 kPa,但无显著差异。此外,我们比较了有(中位=46.5 kPa,SD=22.2 kPa)和无(中位=31.0 kPa,SD=63.1 kPa)可触及异常的前列腺内器官 EM 差异。
这项工作发现,病变的前列腺组织比正常组织更硬,随着疾病严重程度的增加,硬度增加,即使在一个前列腺内也存在很大的样本间差异。对晚期癌症的进一步研究将有助于加强本工作中的发现。