Guy L, Bégin L R, Al-Othman K, Chevalier S, Aprikian A G
Department of Urology, Research Institute, Montreal General Hospital, McGill University, Quebec, Canada.
Br J Urol. 1998 Nov;82(5):738-43. doi: 10.1046/j.1464-410x.1998.00812.x.
To define the distribution of neuroendocrine (NE) cells in the different compartments of the verumontanum (utricle, ejaculatory ducts, main prostatic ducts) in relation to other areas of the prostate.
A retrospective study was conducted of 30 radical prostatectomy specimens processed in toto as whole-mount sections. Among these cases, 15 patients had received a preoperative short course of total androgen blockade. The distribution and number of NE cells in the prostatic utricle and in normal areas of the prostate were analysed using chromogranin A (CgA) and serotonin immunohistochemistry; prostate-specific antigen (PSA) immunostaining was performed systematically on a consecutive section. Six cases of endometrioid carcinomas were also investigated using these methods. The vascularization of the verumontanum was assessed by factor VIII immunohistochemistry and examined in relation to vascular endothelial growth factor (VEGF) immunohistochemistry.
There were significantly more NE cells in the prostatic utricle than in the main prostatic ducts of the verumontanum and the peripheral prostatic acini. In the ejaculatory ducts. there were NE cells only in the extreme distal portion. Cells immunoreactive for PSA were present at the level of the utricle and the extreme distal portion of the ejaculatory ducts. The distribution, number and shape of NE cells were unaltered by hormonal treatment. NE cells of the verumontanum were positive for VEGF expression. Factor VIII detected more vessels around the utricle and ejaculatory ducts. NE cells (positive for CgA and serotonin) were observed in three cases of endometrioid carcinoma.
The high concentration of NE cells found in the prostatic utricle suggests a possible role for these cells in human fertility. Moreover, neuroendocrine differentiation in endometrioid (large duct) carcinoma, documented for the first time, supports the concept that this cancer type is a variant of a conventional adenocarcinoma.
明确前列腺小囊（膀胱颈、射精管、前列腺主导管）不同区域神经内分泌（NE）细胞的分布情况，并与前列腺其他区域进行对比。
对30例前列腺根治性切除标本进行回顾性研究，将其制成整体切片。其中15例患者术前接受了短期全雄激素阻断治疗。采用嗜铬粒蛋白A（CgA）和血清素免疫组化法分析前列腺小囊及前列腺正常区域NE细胞的分布和数量；在连续切片上系统进行前列腺特异性抗原（PSA）免疫染色。还采用这些方法对6例子宫内膜样癌进行了研究。通过因子VIII免疫组化评估前列腺小囊的血管生成情况，并与血管内皮生长因子（VEGF）免疫组化结果进行对照研究。
前列腺小囊中NE细胞数量显著多于前列腺小囊的主导管及前列腺外周腺泡中的NE细胞。在射精管中，仅最远端部分存在NE细胞。PSA免疫反应阳性细胞出现在膀胱颈及射精管最远端水平。激素治疗未改变NE细胞的分布、数量及形态。前列腺小囊的NE细胞VEGF表达呈阳性。因子VIII检测显示膀胱颈和射精管周围血管较多。在3例子宫内膜样癌中观察到NE细胞（CgA和血清素呈阳性）。
前列腺小囊中发现的高浓度NE细胞提示这些细胞在人类生育中可能发挥作用。此外，首次记录到的子宫内膜样（大导管）癌中的神经内分泌分化支持了这种癌症类型是传统腺癌变体的观点。
