Deering R E, Bigler S A, King J, Choongkittaworn M, Aramburu E, Brawer M K
Department of Urology, University of Washington, Seattle.
Urology. 1994 Jul;44(1):64-70. doi: 10.1016/s0090-4295(94)80011-1.
Human benign prostatic hyperplasia (BPH) consists of three major histologic components: stroma, epithelium, and luminal space. For the relief of bladder outlet obstruction caused by BPH, quantitation of the histologic composition of BPH may aid in selecting treatment. To investigate variation between patients in the stromal percentage of BPH, we performed quantitative morphometry on specimens from patients with clinically significant bladder outlet obstruction obtained by three procedures: open prostatectomy, transurethral resection of the prostate (TURP), and prostate needle biopsy (PNB) just prior to TURP.
Ten specimens obtained by each surgical procedure were analyzed. Specimens were stained with antibody to muscle-specific actin to mark the stroma; quantitation of stroma was accomplished by computer image analysis.
The percentage of stroma in all BPH cases ranged from 49.9% to 76.7% (mean, 65.4%, SD = 7.4). No significant difference was observed when comparing samples obtained by the three procedures (p = 0.70). Smooth muscle stromal composition was also quantified in PNB specimens. For these samples, a significant inverse relationship was found between the percentage stroma in the biopsy and the percentage of stroma composed of smooth muscle (r2 = 0.49; p = 0.021).
The data demonstrated that the largest component of BPH was stroma, which comprised approximately 50% to 75% of the total hyperplastic tissue. The mean and range of stromal percentage were similar whether investigating large tissue samples from open prostatectomies or small samples from needle biopsies. PNB data indicated that an increased percentage of stroma may be due to increased nonmuscular elements in the stroma.
人类良性前列腺增生（BPH）由三个主要组织学成分组成：基质、上皮和管腔间隙。为缓解BPH所致的膀胱出口梗阻，对BPH组织学组成进行定量分析可能有助于选择治疗方法。为研究BPH患者间基质百分比的差异，我们对通过三种手术获得的、有临床意义的膀胱出口梗阻患者的标本进行了定量形态学分析，这三种手术分别为开放性前列腺切除术、经尿道前列腺电切术（TURP）以及TURP术前的前列腺穿刺活检（PNB）。
对每种手术获得的10个标本进行分析。标本用抗肌肉特异性肌动蛋白抗体染色以标记基质；通过计算机图像分析对基质进行定量。
所有BPH病例中基质百分比范围为49.9%至76.7%（平均65.4%，标准差=7.4）。比较三种手术获得的样本时未观察到显著差异（p = 0.70）。还对PNB标本中的平滑肌基质组成进行了定量。对于这些样本，在活检标本中基质百分比与平滑肌组成的基质百分比之间发现了显著的负相关关系（r2 = 0.49；p = 0.021）。
数据表明BPH的最大成分是基质，约占增生组织总量的50%至75%。无论是研究开放性前列腺切除术的大组织样本还是穿刺活检的小样本，基质百分比的均值和范围都相似。PNB数据表明基质百分比增加可能是由于基质中非肌肉成分增加所致。
