再次经尿道前列腺切除患者前列腺组织学特征及其临床意义  

Histological characteristics of the prostate in men who receive re-TURP for benign prostatic hyperplasia and their clinical significance

作　　者：孙庆增[1] 管同郁[2] 戚景光[2] 曹敬毅[2] 吴刚[2] 杨宁[2] 承征宇[2] 梁杰[2] 王乾[2] 

机构地区：[1]江苏大学临床医学院,江苏镇江212013 [2]徐州市肿瘤医院泌尿外科,江苏徐州221005

出　　处：《中华男科学杂志》2010年第2期118-122,共5页National Journal of Andrology

基　　金：徐州市科技局计划项目(XM07C048)~~

摘　　要：目的:探讨再次经尿道前列腺切除术(TURP)患者前列腺组织的病理组织学特征及其临床意义。方法:选取再次TURP手术的50例患者前后两次手术标本(再次TURP组)和50例仅有一次手术患者的标本(对照组)。采用免疫组织化学S-P法检测前列腺组织中CD34、VEGF、AR的表达,计算微血管密度(MVD)值及VEGF、AR指数,并对再次TURP组首次标本和对照组标本、再次TURP组两次手术标本分别进行比较及统计学分析。结果:VEGF、AR在所有标本中均有表达。再次TURP组首次标本中MVD值、VEGF指数、AR指数分别为:35.83±20.92、7.55±2.72、6.17±1.86,再次手术的标本为:32.16±16.65、7.06±2.36、6.99±2.44;对照组为:20.56±6.99、4.28±2.62、4.16±1.34。再次TURP组首次标本MVD值、AR、VEGF指数均高于对照组,两组差异有统计学意义(P<0.05);而再次TURP组前后两次手术标本间各指标差异无统计学意义(P>0.05)。相关分析发现,AR指数和VEGF指数、VEGF指数和MVD值、AR指数和MVD值之间均存在正相关,相关系数(r)分别为:0.650、0.705、0.525(P<0.05)。结论:BPH患者前列腺组织中高MVD值及AR、VEGF的高表达是导致其TURP术后复发及再次手术的重要原因之一,可作为判断术后复发的危险因素及采取针对性预防措施的指标。Objective：To investigate the pathohistological characteristics of the prostate tissues in patients who receive a second TURP and to evaluate their clinical significance.Methods：We collected surgical specimens from 50 cases of TURP（the control group） and another 50 cases of re-TURP（the re-TURP group）,detected the expressions of CD34,vascular endothelial growth factor （VEGF） and androgen receptor（AR） in the prostate tissues by immunohistochemistry（S-P）,and determined mierovessel density （MVD） and the expressions of VEGF and AR.We performed statistical analyses on the results obtained from the specimens of the control group as well as from those of the first and second operations of the re-TURP group.Results：VEGF and AR expressed in all the specimens.The expressions of VEGF and AR and MVD were significantly higher in the re-TURP group than in the controls（P〈0.05）,but showed no significant differences between the first and second operations in the re-TURP group（P〈0.05）.Positive correlations were found between the expressions of AR and VEGF,VEGF and MVD,and AR and MVD（r=0.650,0.705 and 0.525, P〈0.05）.Conclusion：Increased AR,VEGF and MVD in the prostatic tissues may be one of the important causes of recurrence of BPH after TURP,and could be considered as the risk factors for postoperative recurrence and targeted indicators for preventive measures.

关 键 词：良性前列腺增生 再次经尿道前列腺电切术 血管内皮生长因子 雄激素受体 微血管密度 

分 类 号：R699.8[医药卫生—泌尿科学]