Cadeddu J A, Pearson J D, Lee B R, Landis P, Partin A W, Epstein J I, Carter H B
Department of Urology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Urology. 1995 May;45(5):795-800. doi: 10.1016/s0090-4295(99)80086-7.
Pretreatment knowledge of prostate gland histology would allow a more scientifically based selection of medical therapy for men with benign prostatic hyperplasia (BPH) and may increase the effectiveness of the pharmacologic agents available. Changes in prostate-specific antigen (PSA), or PSA velocity, may reflect prostatic epithelial growth in BPH. Our objective was to determine if PSA velocity prior to diagnosis correlated with the relative amount of epithelium in BPH tissue.
We evaluated 39 men with BPH who had serial PSA determinations (mean, 5.4) on frozen sera from 2.3 to 25.1 years before diagnosis, and archival material from simple prostatectomy available for pathologic evaluation. We used an immunoenzymatic staining technique for PSA to bind prostatic epithelium selectively so that color differences in the stained tissue sections could be used to quantify stroma, epithelium, and glandular lumina.
The average percentage of epithelium (%E) was 12.4 and the average stroma-epithelial ratio (SER) was 6.6. The correlation of PSA velocity for the three visits nearest to prostatectomy (n = 32) versus %E and SER was significant (P = 0.003 for both). The PSA value nearest to prostatectomy (n = 39) was directly correlated with %E and SER (P = 0.0001 and P = 0.001, respectively).
These data suggest that PSA and PSA velocity are directly related to the histologic makeup of the prostate in men with BPH. Thus, pretreatment evaluation of PSA could be useful as part of an evaluation to direct BPH therapy.
对前列腺组织学的预处理知识将有助于为良性前列腺增生（BPH）男性患者更科学地选择药物治疗，并可能提高现有药物的疗效。前列腺特异性抗原（PSA）或PSA速率的变化可能反映BPH中的前列腺上皮生长。我们的目的是确定诊断前的PSA速率是否与BPH组织中上皮的相对含量相关。
我们评估了39例BPH男性患者，他们在诊断前2.3至25.1年对冷冻血清进行了系列PSA测定（平均5.4次），并且有前列腺单纯切除术的存档材料可用于病理评估。我们使用免疫酶染色技术使PSA选择性结合前列腺上皮，以便利用染色组织切片中的颜色差异来量化基质、上皮和腺腔。
上皮的平均百分比（%E）为12.4，平均基质-上皮比（SER）为6.6。最接近前列腺切除术的三次就诊（n = 32）的PSA速率与%E和SER的相关性显著（两者P = 0.003）。最接近前列腺切除术时的PSA值（n = 39）与%E和SER直接相关（分别为P = 0.0001和P = 0.001）。
这些数据表明，PSA和PSA速率与BPH男性患者前列腺的组织构成直接相关。因此，PSA的预处理评估作为指导BPH治疗评估的一部分可能是有用的。
