Wespes E, Raviv G, Vanegas J P, Decaestecker C, Petein M, Danguy A, Schulman C C, Kiss R
Department of Urology, Erasme Hospital, Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium.
J Urol. 1998 Dec;160(6 Pt 1):2054-7. doi: 10.1097/00005392-199812010-00031.
Alteration of intracavernous smooth muscle cells has been demonstrated in patients with pure venous leakage. This modification seems correlated with reduction of intracavernous oxygen tension. However, Doppler imaging of the cavernous arteries in these patients is normal. To understand the ischemic factor we studied the endothelium of the terminal arteries with computerized image analysis and immunohistochemical staining with 2 types of lectin in patients with venous leakage and those with normal erections. Lectins are glycoproteins that can be used as histological markers to monitor functional and pathological changes.
Four patients 44 to 59 years old with normal erections who were operated on for penile cancer and 11 patients 27 to 62 years old with pure venous leakage (flow to maintain erection greater than 15 ml. per minute and cavernous flow velocity greater than 35 cm. per second) were included in the study. Immunohistochemical staining with 2 lectins, wheat germ agglutinin and Ulex europeaus agglutinin I, was performed and analyzed with computerized image analysis. The labeling index which relates to the percentage of staining indicates the distribution of the endothelial cells, and mean optical density which relates to the staining intensity indicates the function of these cells.
Mean labeling index values for the 2 lectins were similar in both groups (p >0.05). Mean optical density values for the 2 lectins were significantly greater for the patients with normal erections (p <0.01). Therefore, the distribution of the endothelial cells was the same while their function was different in patients with corporeal veno-occlusive dysfunction.
Staining with wheat germ agglutinin and Ulex europeaus agglutinin I lectin types allowed us to detect alteration in the glyco-histochemistry of the endothelial cells of the small arteries, and venous leakage could be the first step in vasculogenic impotence.
已证实在单纯静脉漏患者中海绵体内平滑肌细胞发生改变。这种改变似乎与海绵体内氧张力降低相关。然而，这些患者海绵体动脉的多普勒成像正常。为了解缺血因素，我们用计算机图像分析和两种凝集素的免疫组化染色研究了静脉漏患者和勃起功能正常者终末动脉的内皮。凝集素是糖蛋白，可作为组织学标志物来监测功能和病理变化。
研究纳入4例44至59岁因阴茎癌接受手术且勃起功能正常的患者，以及11例27至62岁的单纯静脉漏患者（维持勃起的血流大于每分钟15毫升且海绵体血流速度大于每秒35厘米）。用两种凝集素，即麦胚凝集素和荆豆凝集素I进行免疫组化染色，并通过计算机图像分析进行分析。与染色百分比相关的标记指数表明内皮细胞的分布，与染色强度相关的平均光密度表明这些细胞的功能。
两组中两种凝集素的平均标记指数值相似（p>0.05）。勃起功能正常患者的两种凝集素的平均光密度值显著更高（p<0.01）。因此，在海绵体静脉闭塞功能障碍患者中，内皮细胞的分布相同而功能不同。
用麦胚凝集素和荆豆凝集素I型染色使我们能够检测小动脉内皮细胞糖组织化学的改变，并且静脉漏可能是血管性阳痿的第一步。
