[良性前列腺增生中定量形态学与α-肾上腺素能阻滞剂临床反应的关系]

[Relationship between the quantitative morphometry and the clinical response to alpha adrenergic blocker in benign prostatic hyperplasia].

作者信息

Sakai S, Shimazaki J

机构信息

Department of Urology, Chiba University School of Medicine, Japan.

出版信息

Nihon Hinyokika Gakkai Zasshi. 1996 Mar;87(3):695-701. doi: 10.5980/jpnjurol1989.87.695.

DOI:10.5980/jpnjurol1989.87.695

PMID:8709447

Abstract

BACKGROUND

There have been few reports on the relationship between the prostatic tissue components and the effect of alpha adrenergic blocker on urination. The present study was undertaken to correlate the rates of the prostatic tissue components and the clinical response to alpha adrenergic blocker in benign prostatic hyperplasia.

METHODS

40 patients with symptomatic benign prostatic hyperplasia were treated with 0.2 mg/day tamsulosin, a alpha adrenergic blocker, for 4-8 weeks followed by transurethral resection of the prostate. The mean weight of resected prostatic tissues was 25.2 g (range 5-96 g). Specimens were stained with antibodies to muscle-specific actin and to prostate-specific antigen for the detection of the smooth muscle and the glandular epithelium, respectively. Double-immunoenzymatic stained tissue sections were divided into four groups: smooth muscle, connective tissue, glandular epithelium, and glandular lumen. The rates of the areas of respective prostatic tissue components were evaluated with computer-assisted quantitative color image analysis.

RESULTS

The mean rate of the area of smooth muscle, connective tissue, glandular epithelium, and glandular lumen was 32.7%, 46.9%, 10.8%, and 9.6%, respectively. International prostatic symptom score, maximum flow rate and residual urine volume before the treatment were not related to the rates of respective prostatic tissue components. International prostatic symptom score and residual urine volume were reduced and maximum flow rate was increased after the treatment with tamsulosin. A significant relationship was proved between the rate of smooth muscle and the change in maximum flow rate. The large hyperplastic adenoma contained less smooth muscle and showed a lower sensitivity to alpha adrenergic blocker than the small one.

CONCLUSION

The clinical response to alpha adrenergic blocker was related to the rate of smooth muscle in benign prostatic hyperplasia.

摘要

背景

关于前列腺组织成分与α肾上腺素能阻滞剂排尿效果之间的关系，报道较少。本研究旨在探讨良性前列腺增生症中前列腺组织成分的比例与α肾上腺素能阻滞剂临床反应之间的相关性。

方法

40例有症状的良性前列腺增生症患者，接受每日0.2mg坦索罗辛（一种α肾上腺素能阻滞剂）治疗4 - 8周，随后行经尿道前列腺切除术。切除的前列腺组织平均重量为25.2g（范围5 - 96g）。标本分别用抗肌肉特异性肌动蛋白抗体和抗前列腺特异性抗原抗体染色，以检测平滑肌和腺上皮。双重免疫酶染色的组织切片分为四组：平滑肌、结缔组织、腺上皮和腺腔。通过计算机辅助定量彩色图像分析评估各前列腺组织成分的面积比例。

结果

平滑肌、结缔组织、腺上皮和腺腔的平均面积比例分别为32.7%、46.9%、10.8%和9.6%。治疗前的国际前列腺症状评分、最大尿流率和残余尿量与各前列腺组织成分的比例无关。坦索罗辛治疗后，国际前列腺症状评分和残余尿量降低，最大尿流率增加。平滑肌比例与最大尿流率的变化之间存在显著相关性。较大的增生性腺瘤所含平滑肌较少，对α肾上腺素能阻滞剂的敏感性低于较小的腺瘤。