Epidemiological survey of benign prostatic hyperplasia and prostatic cancer in China

Objective To evaluate the prevalence of benign prostatic hyperplasia (BPH) and prostatic cancer (CaP) in the mainland of China.
Methods The incidence of BPH and CaP in urological hospital was investigated in 1997 in 26 provinces and 4 metropolises scattered over the mainland of China. The change of hospital incidences of BPH and CaP in the Institute of Urology, Beijing Medical University from 1951 to 1997 was also reviewed. Results The incidence of BPH and CaP in 1997 in 187 hospitals scattered over the mainland of China was 16.1% (15 459/95 749) and 1.5% (1389/95 749), respectively. The incidence of BPH and CaP in the Institute of Urology, Beijing University from 1951 to 1960 was 7.6% and 0.6%, respectively, while it was 18.5% and 3.4% from 1991 to 1997.
Conclusion The hospital incidence of BPH and CaP is rising rapidly in China, but CaP is still not a common disease in China.      

我国良性前列腺增生和前列腺癌发病调查

目的:通过调查了解我国良性前列腺增生和前列腺癌发病现状。方法:调查全国30个省、市、自治区187所医院1997年泌尿外科住院病人中良性前列腺增生和前列腺癌所占的比例及北京医科大学泌尿外科研究所1951～1997年间住院病人中以上两病构成比变化。结果:全国187所医院1997年泌尿外科住院病人95749例,良性前列腺增生15459例(16.1%),前列腺癌1389例(1.5%)。所有医院都认为无论良性前列腺增生还是前列腺癌近年都有明显增长。北京医科大学泌尿外科研究所50年代良性前列腺增生和前列腺癌分别占住院病人7.6%和0.6%;90年代分别上升至18.5%和3.4%。结论:我国良性前列腺增生已成为泌尿外科最常见的疾病之一,前列腺癌的发生虽有增长仍远低于欧美国家。     

Changing constituents of genitourinary cancer in recent 50 years in Beijing

Objective To assess the changes in constituents of genitourinary cancer inpatients in Beijing following the growing economy of China.Methods Urological inpatients treated from January 1951 to December 2000 at the Institute of Urology, Peking University were studied restrospectively.Results In the period of about 50 years 28 474 urological inpatients were reviewed. Cancer patients aged 0-25 years and 26 -50 years comprised 19.5% and 28.2%, respectively. Since the 1970s the incidence rates of renal cancer and prostate cancer increased dramatically from 10. 4% to 28. 7% and from 3. 3% to 13.4%, respectively.Conclusion The introduction of new diagnostic instruments, the expansion of the aged population and a high fat diet are considered to be responsible for the change of constituents of genitourimary concer inDatients.     

The usefulness of prostate specific antigen density as a screening method for prostatic carcinoma

Prostate specific antigen (PSA) has been used extensively for monitoring the progression of prostatic cancer since its discovery in 1979. Unfortunately the measurement of PSA in serum is not sufficiently specific for early detection of prostatic carcinoma (CaP) as it is secreted by normal as well as hyperplastic or cancerous prostatic tissue. As serum PSA is the reflection of the number of prostatic epithelial cells, a small cancerous prostate gland having increased number of cells per unit volume leaks more PSA in serum than a benign, large gland. Thus the concept of PSA density (PSAD) has been proposed (the quotient of serum PSA divided by the volume of prostate in cubic centimeter) as an indicator for prostatic malignancy. In the present study pre-operative PSAD values of 65 cases of prostatic diseases were calculated [54 cases of benign prostatic hyperplasia (BPH) and 11 cases of C3P]. Serum PSA was measured by enzyme linked immunosorbent assay (ELISA) method and the prostatic volume was measured by transrectal ultrasonography (TRUS). Although 8 cases of BPH (14.8%) had raised PSA level, abnormal PSAD (0.1 or above) was noted in only 3 cases. All cases having PSAD value above 0.2 had carcinoma. The PSAD value above 0.1 in cases of CaP was found to be significant (p<0.001). By using PSAD as screening test the sensitivity increased from 85.1% to 94.4% and positive predictive value increased from 55.5% to 75%, compared to the detection of carcinoma by measuring PSA alone. The present study concludes that PSAD is more useful for prediction of CaP and the need of prostatic biopsy for early detection.     

A histopathological study of prostate lesions in Lagos,Nigeria: A private practice experience

Introduction:

Prostatic carcinoma (CaP) is globally the second most frequently diagnosed cancer and the sixth leading cause of cancer death in males. The aim of this study is to determine the pattern of histopathological types of prostatic lesions seen in a private laboratory in Lagos, Nigeria.

Materials and Methods:

Histopathological reports of all prostate specimens, which were received and processed by histopathology section of a private laboratory in Lagos, Nigeria, from August 2009 to December 2013 were reviewed.

Results:

A total of 304 prostatic tissue specimens were received and processed during the period under review. The youngest patient was 32 years old while the oldest patient was 99 years old with a mean of 67.8 years ± 9.5. The most common diagnosis was benign prostatic hyperplasia (BPH) (62.8%), distantly followed by CaP (29.3%), inadequate samples (6.6%), prostatic intraepithelial neoplasia (1%), and metastasis to the prostate (0.3%). The peak incidence was age group of 60-69 years, closely followed by 70-79 years accounting for 38.2% and 36.2%, respectively. Moderately differentiated CaP (Gleason scores [GSs] 5-7) accounted for 58.1% of the cases while GS 7 was the most common individual score and was seen in 32.3% of the CaP cases.

Conclusion:

In this private practice, BPH is the most common prostate lesion. CaP is relatively high and most of the cases have a high GS that portends high mortality in our population. Efforts should be made to increase awareness so as to reduce the mortality.     

良性前列腺增生症合并慢性前列腺炎的临床研究

目的探讨前列腺增生症（BPH）与慢性前列腺炎（CP）的关系及临床特点。方法对2009年1月—2011年12月我院泌尿外科收治的96例良性BPH患者的年龄、病程、国际前列腺症状评分（IPSS）、前列腺体积、PSA水平等项目进行回顾性分析研究。结果 96名研究对象总体的慢性前列腺炎的发生率为68.75%。合并慢性前列腺炎患者的年龄、病程、IPSS评分、前列腺体积及PSA水平显著高于单纯前列腺增生组。结论前列腺炎症在BPH的进展中起着重要作用,同时炎症可能会加重BPH患者的下尿路症状,应给予积极治疗。     

Efficacy and safety of tamsulosin for the treatment of benign prostatic hyperplasia: a meta analysis

Background Pharmacological therapy has been considered as the first-line treatment for patients with uncomplicated benign prostatic hyperplasia （BPH）. The aim of this study was to evaluate the efficacy and safety of tamsulosin compared with a placebo for treating BPH. Methods The randomized placebo-controlled trials （RCT） of tamsulosin for the treatment of BPH from all over the world were searched. PubMed, Ovid, ScienceDirect, EBSCO, CBM, and CNKI were searched, as well as a manual search of four Chinese journals： Chinese Journal of Andrology, National Journal of Andrology, Chinese Journal of Urology, and Journal of Clinical Urologywas also performed. Two reviewers independently screened the studies for eligibility, evaluated the quality and extracted the data from the eligible studies, with confirmation by cross-checking. Divergences of opinions were settled by discussion. Meta-analysis was processed by Rev Man 5.0 software, fail-safe number was performed by SASS.0 software. Results Seven RCTs involving 2455 men met the inclusion criteria. The basic characteristics of patients were comparable in all the studies. Comparing three common criteria： international prostate symptom score （IPSS）/Boyarsky symptom score, maximum flow rate （MFR）, quality of life （QOL）, tamsulosin was better than placebo at improving IPSS and MFR, with no significant difference in the QOL. Adverse events of tamsulosin also showed no significant difference from the placebo group （Z=1.62, P=0.10, OR=1.22, 95% Cl 0.96-1.54）. Conclusions Tamsulosin is better than placebo at improving IPSS and MFR. Adverse events of tamsuloisn show no significant difference compared with placebo. More high quality trials with larger samples and longer follow-up are proposed.     

原发性高血压与良性前列腺增生的相关性研究

目的探讨原发性高血压与良性前列腺增生(BPH)发生与进展的相关性。方法对临床明确诊断BPH的195例患者的临床资料,其中95例BPH合并高血压组,100例为单纯BPH患者组。对两组的IPSS评分、血清前列腺特异性抗原(PSA)、前列腺体积、残余尿量及最大尿流率指标进行比较。结果 BPH合并高血压组患者的IPSS评分、PSA和前列腺体积明显大于单纯BPH组(P<0.05)。舒张压≥90 mmHg组患者的前列腺体积大于舒张压<90 mmHg组,有统计学意义(P<0.05);而收缩压≥140 mmHg组与收缩压<140 mmHg组患者各指标比较均无明显差异。与单纯BPH组的各项临床指标相比,BPH合并高血压组中10年以上高血压病史患者的BPH前列腺体积明显增大(P<0.05)。结论 BPH同时合并高血压多见,长期高血压尤其是高舒张压状态能够促进BPH的发生以及临床进展。     

膳食钠盐、体质量指数与良性前列腺增生关系的研究

目的 探讨老年男性膳食钠盐、体质量指数(BMI)与良性前列腺增生(BPH)危险性之间的关系.方法 采取以医院为基础的病例对照研究.研究组由经组织学检查证实患BPH的男性患者组成,对照组由因患其他疾病入住与研究组患者相同医院的同期患者组成.研究组与对照组各360例,1∶1匹配.采用标准调查表对全部研究对象进行问卷调查,同...     

坦索罗辛治疗良性前列腺增生疗效及安全性的Meta分析

目的 评价坦索罗辛(tamsulosin)在安慰剂对照下治疗BPH的疗效以及安全性. 方法 搜集世界范围内运用坦索罗辛和安慰剂对比治疗BPH随机对照试验(RCT)的英文及中文文献,并追查已纳入文献的参考文献.计算机检索:Pubmed,Ovid,ScineceDirect,NGC,EKSCO,EMBASE,CNKI,CBM;手工检索:<中华泌尿外科杂志>、<临床泌尿外科杂志>、<中国男科学杂志>、<中华男科学杂志>四种相关杂志.由两位系统评价员做独立文献筛查、质量评价和资料提取,并交叉核对,不同意见时经过讨论或请第三者裁决.使用统计软件Rev Man5.0完成Meta分析,SAS8.0计算失安全系数. 结果 经筛选,最后纳入7篇文献,均是以安慰剂作对照的RCT,包括受试患者2 263例,进行Meta分析,其基线情况具有可比性.通过比较用药前后3个判效指标,即国际前列腺症状评分(IPSS)/Boyarsky症状评分、最大尿流率(MFR)发现坦索罗辛均优于安慰剂,且经统计学分析后均有统计学意义;生活质量(QOL)的评价仅纳入1篇文献,结果 尚不能认为两组间有差异;其不良反应与安慰剂相比差异无统计学意义[Z=1.62(P=0.10),OR为1.22,95%CI(0.96,1.54)]. 结论 坦索罗辛能够改善良性前列腺增生引起的相关症状(IPSS,MFR),其疗效优于安慰剂,不良反应与安慰剂相比无差异.建议进行大样本、长期随访的高质量临床试验,提供更佳循证证据.     

前列腺增生表皮生长因子受体和雌激素受体的免疫组化研究

用免疫组化方法对１９例前列腺增生，６例前列腺癌及４例正常前列腺组织中ＥＧＦＲ和ＥＲ的表达进行观察，结果上述三组ＥＧＦＲ阳性率分别为５７．９％，８３．３％和１００％，ＢＰＨ组ＮＰ组相关不显著；ＥＲ阳性率分别为１００％、６６．７％，２５；０％，ＢＰＨ组高于ＮＰ及ＣａＰ组；前列腺增生ＥＧＦＲ与ＥＲ的表达无显著相关。     

钬激光用于良性前列腺增生的治疗进展

良性前列腺增生（Benign prostatic hyperplasia,BPH）是中老年男性常见病、多发病,临床症状以排尿困难、膀胱刺激症状为主,病情进一步发展时,患者会出现尿潴留、肾积水等严重并发症,严重影响患者的生活质量,此时,患者需接受以手术为主的综合干预措施。伴随钬激光技术在泌尿外科领域的大力推广,经尿道钬激光剜除良性前列腺增生的手术方式越来越炙热化,自2016 年起,就已被欧洲泌尿外科指南予以推荐。笔者就近年来钬激光技术应用于BPH 的相关原理、发展史、现状及发展前景做一综述。     

良性前列腺增生微创术后尿道狭窄的危险因素分析

目的 基于列线图分析良性前列腺增生（BPH）微创术后尿道狭窄（US）的危险因素。方法 选取2019年1月—2022年1月在天水市第二人民医院行微创术的BPH患者162例，术后随访6个月，统计US发生情况，分为US组、无US组。比较两组患者一般资料；采用多因素Logistic逐步回归模型分析BPH微创术后US的危险因素；建立BPH微创术后US的列线图风险模型，并评估其效能及预测价值。结果 随访6个月后，BPH行微创术患者US发生率为18.52%(30/162)。US组与无US组患者尿路感染、手术操作不规范、术中行尿道扩张、术后导尿管留置时间> 14 d构成比比较，差异均有统计学意义（P <0.05）。多因素Logistic逐步回归分析结果显示，尿路感染[■=6.521(95%CI:4.568,8.474)]、手术操作不规范[■=3.789(95%CI:1.254,6.323)]、术中行尿道扩张[■=2.818(95%CI:1.986,3.650)]、术后导尿管留置时间> 14 d [■=2.683(95%CI:1.365,4.001)]为BPH微创术后US的危险因素（P...     

Histopathological review of prostatic diseases in Kano,Nigeria

Diseases of the prostate are common causes of morbidity in adult males and show wide geographical and ethnic variations in incidence and mortality worldwide. It is in the light of this that records of prostatic biopsies were reviewed in retrospect at the Aminu Kano Teaching Hospital, Kano and Murtala Mohammed Hospital Kano over a 4-year period in order to determine the histological pattern and age distribution of the various prostatic lesions. Three hundred and three prostatic lesions constituting 7.4% of all surgical biopsy specimens received were studied. Two hundred and thirty five (77.6%) of these were cases of BPH while prostatic cancer accounted for 22.4% of cases. The ratio of benign to malignant prostatic disease was 3:5:1. Chronic non-specific prostatitis, acute prostatitis, schistosomiasis and tuberculosis were present in 22.8%, 3.3%, 0.7% of the total number of cases respectively. The mean age of BPH patients was 63.7 years, and 88% of them had a glandulostromal histological pattern. Majority (64.2%) of the prostate cancers were well-differentiated adenocarcinoma and the mean age was 67.1 years. The findings confirm earlier observations that prostatic diseases are common causes of morbidity in our environment, and early diagnosis and treatment remain key measures in reducing mortality. The practice of 5-region biopsy is advocated to improve detection of clinical prostate cancer.     

Impact of primary hypertension on hematuria of the patients with benign prostatic hyperplasia

Background Both benign prostatic hyperplasia （BPH） and primary hypertension are common in the elderly men. The purpose of this study was to investigate the possible effect of primary hypertension on the hematuria in patients with BPH.Methods All patients who underwent transurethral resection of prostate or opening operation had confirmed diagnoses of BPH histologically. comparative analysis of packet was used to analyze the incidence of hematuria in 423 BPH patients with or without hypertension. Immunostaining of CD34 and vascular endothelial growth factor （VEGF） was carried out in tissues of 50 cases of simple BPH and 50 cases of BPH accompanied with hypertension. Results The incidence of hematuria in the BPH with hypertension was significantly higher than that in the simple BPH （P〈0.01）. Furthermore, the incidence of hematuria in patients who had hypertension for more than 10 years was clearly higher than that in the patients who had hypertension for less than 10 years （P 〈0.01）. Both microvessel density （MVD） based on CD34 immunostaining and VEGF expression were significantly higher in the BPH tissues of patients with hypertension than that in the simple BPH （P〈0.01, P〈0.05）.Conclusions Long-term hypertension may significantly increase the incidence of hematuria in patients with both BPH and hypertension. Increased MVD level and VEGF expression may account for the higher incidence of hematuria in these patients.     

消癃合剂治疗良性前列腺增生症的临床研究

目的观察消癃合剂治疗良性前列腺增生症(BPH)的临床疗效。方法将60例BPH患者随机分为治疗组与对照组,治疗组(30例)口服消癃合剂,对照组(30例)口服癃闭舒。观察治疗前后患者的排尿症状评分、生活质量指数、前列腺体积、最大尿流率和膀胱残余尿量的变化。结果治疗组总有效率为86.67%,对照组为73.33%,经统计学处理无显著性差异(P>0.05)。但治疗组在减轻患者的排尿症状评分、改善生活质量指数、提高最大尿流率和减少膀胱残余尿量等方面,疗效明显优于对照组(P<0.05),而两组在缩小前列腺体积方面作用不明显(P>0.05)。结论消癃合剂为治疗BPH的有效药物。     

前列腺增生症病人合并的前列腺炎症对血清前列腺特异性抗原的影响

目的：探讨前列腺增生症合并的前列腺炎症对病人血清PSA的影响。方法：纳入2006年9-12月期间在四川大学华西医院行经尿道前列腺电切术的前列腺增生症病人52例,术前检查经直肠前列腺B超,检测血清前列腺特异性抗原,记录年龄和是否存在急性尿潴留;术中取切取的前列腺组织采用real-time PCR检测前列腺感染与否。采用Logistic多元回归方法,纳入尿潴留、前列腺感染、前列腺体积和年龄等因素的同时,分析前列腺腺周炎症、前列腺腺体炎症是否与血清前列腺特异性抗原浓度有关。结果：前列腺腺周炎症、前列腺体积与血清PSA升高有关（P值分别为0.027和0.001）。结论：除了前列腺体积外,前列腺腺周炎症是前列腺增生症病人血清PSA升高的危险因素。     

前列腺癌与增生低场磁共振鉴别诊断价值的探讨

目的　分析低场MRI对前列腺癌与增生的诊断及鉴别诊断的价值。方法　收集 18例前列腺癌与 2 2例前列腺增生病例的MRI图像 ,分析其表现和特征。结果　前列腺癌 66.7%发生于外周区 ,信号改变以T2 WI较为明显 ,表现为高信号的周围区内出现异常低信号 ,而前列腺增生则 72 .7%发生于中央区或移行区 ,主要表现为在T2 WI的中央区或移行区中出现高、低、等混合不均的异常信号。结论　低场MRI的T2 WI对前列腺癌和增生有鉴别诊断意义 ,并对于包膜的侵犯与否具有较高的诊断价值。     

GDF15在前列腺癌及其癌前病变中的表达和意义

目的探讨前列腺癌及癌前病变组织中GDFl5基因的表达情况及临床意义。方法运用组织芯片技术及免疫组化SP法检测72例前列腺癌组织（PCa组,其中Gleason评分5～7分42例,〉7分30例）、22例高级别前列腺上皮内瘤组织（PIN组）、23例良性前列腺增生组织（BPH组）中GDFl5蛋白的表达和分布情况。结果GDFl5在PCa、PIN、BPH组中的阳性表达率分别为95．8％、727％、87％;其在PCa及PIN组织中的阳性表达率均明显高于BPH组织（均P〈0．05）,而且在PCa组织中的阳性表达率也明显高于PIN组织（P〈0．05）。中分化PCa组织中GDFl5阳性表达率为92．9％（39／42）,低分化PCa组织中为100．0％（30／30）,差异无统计学意义（P〉0．05）。结论GDFl5在前列腺癌中高表达,对前列腺癌的发生、发展可能起到重要作用。检测GDFl5在正常前列腺组织、高级别PIN、前列腺癌组织中的表达情况。有助于病理学上早期诊断前列腺癌。     

高血压对良性前列腺增生组织中血管新生影响的研究

目的探讨原发性高血压对良性前列腺增生(BPH)组织中血管新生的影响。方法应用免疫组织化学方法检测了50例单纯BPH和50例BPH并发高血压患者的前列腺组织中CD34抗原及血管内皮生长因子(VEGF)的表达,并计算微血管密度(MVD)。结果BPH并发高血压组MVD明显高于单纯BPH组(P<0.01)。BPH并发高血压组内,高血压病程≥15年组MVD明显大于高血压病程<15年组(P<0.05);高血压病程与前列腺容积有明显相关性。BPH并发高血压组VEGF在前列腺间质中的阳性表达率显著高于单纯BPH组(P<0.05)。BPH并发高血压组前列腺组织的MVD与间质中VEGF表达呈显著正相关(r=0.11,P<0.05)。结论高血压与前列腺间质中VEGF的表达升高密切相关。VEGF的表达升高可以诱导血管新生,因此可以促进并发高血压患者BPH的临床进展。