Gardner W A, Culberson D E
J Urol. 1987 Jan;137(1):53-6. doi: 10.1016/s0022-5347(17)43869-9.
Atrophic and proliferative changes in the prostate gland are regarded as beginning in middle age and characterizing the prostates of older men. A total of 51 prostates of men between 19 and 29 years old demonstrated a spectrum of proliferative abnormalities, including ductal and glandular hyperplasia, atypical hyperplasia, dysplasia, carcinoma in situ and incipient adenocarcinoma. The majority of the prostates also contained substantial areas of atrophy. Patterns of atrophic change included cystic dilatation of glands with flattened epithelium apparently secondary to obstructive hyperplasia of ductal epithelium, areas comparable to sclerotic atrophy of the aged prostate and segments having the appearance of a prepubertal unstimulated prostate. These observations contrast sharply with conventional concepts of the biology of the prostate gland, and suggest a number of hypotheses regarding the early antecedents and evolution of prostatic carcinoma and cancer in general.
前列腺的萎缩性和增生性变化被认为始于中年，并是老年男性前列腺的特征。对51例年龄在19至29岁之间男性的前列腺进行检查，发现了一系列增生异常情况，包括导管和腺体增生、非典型增生、发育异常、原位癌和早期腺癌。大多数前列腺还存在大面积萎缩区域。萎缩性变化模式包括腺体的囊性扩张，上皮扁平，显然是继发于导管上皮的阻塞性增生；类似于老年前列腺硬化性萎缩的区域；以及外观类似青春期前未受刺激前列腺的节段。这些观察结果与前列腺生物学的传统概念形成鲜明对比，并提出了一些关于前列腺癌及一般癌症的早期起因和演变的假设。
