Robert M, Costa P, Bressolle F, Mottet N, Navratil H
Service d'Anatomo-Pathologie, CHU G. Doumergue, Nîmes, France.
Br J Urol. 1995 Mar;75(3):317-24. doi: 10.1111/j.1464-410x.1995.tb07342.x.
To determine whether histological analysis of six multiple random biopsies of the gland or analysis of only one biopsy provides a good estimate of the different components of the hyperplastic gland compared with the results obtained from tissue specimens (reference values).
The various components of prostate tissue obtained from 30 men undergoing suprapubic adenomectomy were investigated. The histological analysis was performed on multiple tissue specimens reflecting adenoma (reference values) and on one and six biopsies performed at random on the enucleated material of the hyperplastic gland. Immunohisto chemistry using anti-actin as a label of smooth muscle and specific histological staining coupled with computer-assisted quantitative morphometric analysis was used to ascertain the histological composition of the prostate.
The mean ( +/- SD) area densities obtained from tissue specimens were 34.1 +/- 5%, 32.4 +/- 6.9%, 17.6 +/- 4.5% and 15.9 +/- 5.5% of smooth muscular and fibrous tissue, and epithelium and glandular lumen, respectively. The mean ratio of stromal to epithelial hyperplasia averaged 4.05 +/- 1.73. Both one and six biopsies gave a good estimate of fibrous tissue and glandular epithelium, but the percentage of smooth muscles was overestimated and the percentage of glandular lumen was underestimated. There was a significant relation between the prostate area densities of glandular epithelium (r = -0.41, P < 0.05), the percentage area density of prostate smooth muscle (r = 0.43, P < 0.05), and the weight of enucleated adenoma. No correlation was found with prostate-specific antigen (PSA).
It seems feasible to propose medical treatment of benign prostatic hyperplasia (BPH) based on the histological composition of the prostate gland. One biopsy, reflecting in good proportions the nature of the adenoma, would be used to provide insight into the pathogenesis and therapy of BPH.
确定对腺体进行六次随机多点活检的组织学分析或仅一次活检的分析，与从组织标本获得的结果（参考值）相比，是否能很好地评估增生腺体的不同成分。
对30例行耻骨上腺瘤切除术的男性患者所获得的前列腺组织的各种成分进行研究。对反映腺瘤的多个组织标本（参考值）以及对增生腺体摘除物随机进行的一次和六次活检进行组织学分析。使用抗肌动蛋白作为平滑肌标记的免疫组织化学以及特异性组织学染色结合计算机辅助定量形态计量分析来确定前列腺的组织学组成。
从组织标本获得的平均（±标准差）面积密度分别为平滑肌和纤维组织、上皮和腺腔的34.1±5%、32.4±6.9%、17.6±4.5%和15.9±5.5%。基质与上皮增生的平均比率为4.05±1.73。一次活检和六次活检都能很好地评估纤维组织和腺上皮，但平滑肌的百分比被高估，腺腔的百分比被低估。腺上皮的前列腺面积密度（r = -0.41，P < 0.05）、前列腺平滑肌的面积密度百分比（r = 0.43，P < 0.05）与摘除腺瘤的重量之间存在显著关系。未发现与前列腺特异性抗原（PSA）相关。
基于前列腺的组织学组成提出良性前列腺增生（BPH）的医学治疗方案似乎是可行的。一次活检能很好地反映腺瘤的性质，可用于深入了解BPH的发病机制和治疗。
