Helpap B, Riede C
Institute of Pathology, General Hospital of Singen, University of Freiburg, Federal Republic of Germany.
Pathol Res Pract. 1995 Jun;191(5):381-90. doi: 10.1016/S0344-0338(11)80723-5.
Atypical glandular proliferations of the prostate are found in combination with prostate carcinomas but also with benign prostatic hyperplasia (BPH). These atypical glandular lesions that mimic glandular carcinoma within the anterocentral part of the prostate (transition zone) are named "atypical adenomatous hyperplasia (AAH)." The term for atypical ductal and acinar mainly papillary and/or cribriform proliferations in the peripheral zone is "prostatic intraepithelial neoplasia (PIN)." In this study the significance of the status of nucleoli and the number of silver-stained nucleolar organizing regions (AgNOR) as a method for measuring proliferative activity was investigated in biopsies of AAH, PIN and carcinomas of different grades of malignancy. The aim was to prove whether there are relationships of AAH to low grade carcinomas on the one hand and of PIN to high grade carcinomas on the other hand. The frequency of nuclei with small nucleoli was low in BPH (0.6%). The values increased to 8.3% in AAH, and 28.7% in PIN. The frequency of nuclei with prominent nucleoli in low grade carcinomas was 41.7% and in high grade carcinomas 81.1%. Usually, one single nucleolus was found per nucleus. Multiple prominent nucleoli were found in high grade carcinomas and in some cases of high grade PIN only. The result of AgNOR-analysis was similar: low numbers in BPH, low to moderate values in AAH, moderate values in low grade carcinomas and high values in PIN, as well as high grade carcinomas. Besides correlation between topography, histology and cytology, the similarities of nucleolar and AgNOR-analysis between PIN and high grade carcinomas support the idea that PIN is the precursor of the peripheral prostatic carcinoma. The histological, cytological and cell kinetical features of AAH are intermediate between BPH and low grade carcinoma of the prostate. Therefore, the findings to date are inconclusive and further follow up studies are necessary to prove if AAH may be a precursor of transition zone carcinoma of the prostate.
前列腺非典型腺性增生可见于前列腺癌，也可见于良性前列腺增生（BPH）。这些在前中央部前列腺（移行区）内类似腺癌的非典型腺性病变被称为“非典型腺瘤样增生（AAH）”。外周区非典型导管和腺泡主要为乳头状和/或筛状增生的术语是“前列腺上皮内瘤变（PIN）”。在本研究中，通过对不同恶性程度的AAH、PIN和癌的活检标本进行研究，探讨核仁状态及银染核仁组织区（AgNOR）数量作为测量增殖活性方法的意义。目的是证明一方面AAH与低级别癌之间、另一方面PIN与高级别癌之间是否存在关联。BPH中小核仁细胞核的频率较低（0.6%）。AAH中该值增至8.3%，PIN中为28.7%。低级别癌中核仁突出的细胞核频率为41.7%，高级别癌中为81.1%。通常，每个细胞核可见一个单一核仁。多个突出核仁见于高级别癌以及部分高级别PIN病例中。AgNOR分析结果类似：BPH中数量低，AAH中低至中等，低级别癌中中等，PIN以及高级别癌中高。除了地形学、组织学和细胞学之间的相关性外，PIN与高级别癌之间核仁及AgNOR分析的相似性支持PIN是外周前列腺癌前体的观点。AAH的组织学、细胞学和细胞动力学特征介于BPH和前列腺低级别癌之间。因此，迄今的研究结果尚无定论，需要进一步的随访研究来证明AAH是否可能是前列腺移行区癌的前体。
