Department of Pathology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
Prostate. 2013 Apr;73(5):467-75. doi: 10.1002/pros.22588. Epub 2012 Sep 19.
The objective of this study was comparison of characteristics of the microvasculature in transition zone tumor (TZT) and benign nodular hyperplasia (BPH) with normal prostatic transition zone (NTZ), applying accurate and objective quantification based on digital image analysis. Results of this study may increase understanding of prostate dynamic contrast enhanced (DCE) MRI analysis.
Radical prostatectomy specimens of 28 patients containing TZT ranging from pT2-pT4 were used. In 11 patients a concomitant peripheral zone tumor (PZT) was present. Microvessels were visualized by CD31 immunohistochemistry. Specimens were scanned using a computer-controlled microscope with automatic recognition of microvessels. Pseudocolor maps were produced displaying microvessel density, perimeter, and area of an entire prostate transection. Mean, 75th percentile (p75) and coefficient of variation (CV) were calculated automatically in manually indicated areas of the tumor and corresponding contralateral normal tissue, and BPH.
Large variability was seen in TZT microvascular parameters, indicating presence of patients having both hypo and hypervascularized tumors compared to NTZ. In contrast, areas of BPH showed a more consistent increase in vascular parameters, with decreased CV. Analysis of PZT confirmed results of our previous study, with mean and p75 of all vascular parameters being significantly increased and a decrease in CV. No correlation was found for clinicopathological parameters and microvascular parameters.
Microvasculature of transition zone tumor showed increased heterogeneity compared to BPH and peripheral zone tumors, possibly explaining the difficulty of TZT detection on DCE-MRI.
本研究旨在通过基于数字图像分析的准确客观的量化方法，比较移行区肿瘤（TZT）和良性结节性增生（BPH）与正常移行区（NTZ）的微血管特征。本研究的结果可能有助于增加对前列腺动态对比增强（DCE）MRI 分析的理解。
使用 28 例包含 pT2-pT4 期 TZT 的根治性前列腺切除术标本。11 例患者同时存在外周区肿瘤（PZT）。采用 CD31 免疫组织化学法显示微血管。使用计算机控制的显微镜对标本进行扫描，自动识别微血管。生成伪彩色图，显示整个前列腺横切面的微血管密度、周长和面积。在肿瘤和相应的对侧正常组织及 BPH 的手动指示区域自动计算平均值、第 75 百分位数（p75）和变异系数（CV）。
TZT 的微血管参数存在较大的变异性，表明与 NTZ 相比，存在低血管化和高血管化的肿瘤患者。相比之下，BPH 的血管参数增加更为一致，CV 降低。PZT 的分析证实了我们之前研究的结果，所有血管参数的平均值和 p75 均显著增加，CV 降低。临床病理参数与微血管参数之间无相关性。
与 BPH 和外周区肿瘤相比，移行区肿瘤的微血管显示出更高的异质性，这可能解释了 DCE-MRI 上 TZT 检测的困难。
