前列腺增生症患者血清前列腺特异性抗原升高的病理学研究

目的 :从病理学角度上探讨前列腺增生症 (BPH)患者血清前列腺特异性抗原 (PSA)水平的原因。方法 :应用HE染色和免疫组化技术PSA染色 ,对 1 72例BPH患者手术切除的前列腺组织进行病理分析研究。结果 :单纯间质性炎淋巴细胞浸润 ,如无腺上皮区的破坏 ,血清PSA在正常范围 ;炎症或其他因素累及腺上皮可致血清PSA升高 ,前列腺腺体破坏程度愈大 ,血清PSA升高愈明显。血清PSA水平改变与是否合并慢性前列腺炎无相关性 ,炎症影响为非特异性。血清PSA≥ 1 0ng·ml-1 者 ,免疫组化显示其前列腺间质以及血管中有染色的PSA抗原 ,4ng·ml-1 ≤血清PSA <1 0ng·ml-1 者前列腺间质及血管偶可见PSA染色 ,而血清PSA <4ng·ml-1 者则无。结论 :支持“渗漏学说” :当BPH患者腺体受各种因素影响导致扩张、破坏时 ,PSA渗漏入间质 ,继而进入血液循环 ,血清PSA明显升高。腺体破坏程度决定血清PSA升高程度

Pathological Study of Influence of Beinigh Prostatic Hyperplasia on Serum PSA

Objective: To study the influence of pathologic changes in beinigh prostatic hyperplasia(BPH) on the serum PSA level. Methods: 172 specimen were achieved by operation and detected by immunohistochemistry,H&E and PSA stain. Results: Serum PSA was at nomal level when interstitial prostatitis occurred.The serum PSA level had no significant changes when epithelial cells were affected by inflammation or other factors. The more the destroyed extent of prostate,the higher the level of serum PSA. Whether BPH patients had chronic prostatitis or not,the serum PSA level had no marked differences.It suggested that prostatitis was not a specific factor to cause the increase of serum PSA level. Immunohistochemical staining suggested that PSA antigen expressed at stromal areas and blood vessels of the prostate when serum PSA≥10 ng·ml -1 and expression could be seen occasionally when 4 ng·ml -1 ≤PSA<10 ng·ml -1 .There was no PSA antigen expressed when serum PSA<4 ng·ml -1 .Conclusion: The results supported the “PSA leakage” theory:when the prostates of BPH patients are destroyed by all kinds of factors, PSA would permeat into stromal and enter the blood circulation. The extent to which serum PSA level could rise is determined by the destroyed extent of the prostate.