联合内分泌治疗对前列腺和睾丸的影响

目的 探讨抑那通和缓退瘤联合治疗对正常前列腺,增生的前列腺（ＢＰＨ）和前列腺癌以及睾丸的作用。方法 对１６例接受联合内分泌治疗至少３个月且有治疗前后病理资料的前列腺癌患者的标本进行了系统的病理学检查。对内分泌治疗后的睾丸标本与同龄未接受治疗的进行对照研究。结果 １４例内分泌治疗后的前列腺标本２例未见残存癌灶,９例对治疗有明显的反应;３例对治疗反应差,治疗并未降低前列腺癌的病理分期。３例内分泌治疗后

The effect of combined endocrine therapy on prostate and testis

Objective To study the pathological changes of the effect of combined endocrine therapy on normal prostate, benign prostatic hyperplasia, prostatic adenocarcinoma and testis. Methods 11 radical prostatectomy specimens, 3 core needle biopsies of prostate and 3 testes obtained after at least 3 months of enatone flutamide inhibition therapy were studied. Step section was performed on radical specimens and average 16 sections per case were reviewed. PSA, PSAP and AE1/AE3 were immunostained on 14 cases of prostate cancer and a comparative study pre and post treatment was made. Results No residual tumor was recognized in 2 cases. Such characteristic changes were found in 9 cases as prominent acinar atrophy, decreased ratio of acini to stroma, stromal fibrosis, squamous metaplasia of carcinoma, cytoplasmic vaculation, nuclear shrinkage, and nucleolar shrinkage. No apparent change was discovered in 3 cases. Secretory epithelial atrophy and basal cell hyperplasia were the popular change in BPH and normal prostate. The expressions of both PSA and PSAP were markedly reduced in prostate carcinoma and nonneoplastic glands. Pathological downstaging of the tumor was not found statistically. Epithelial atrophy also existed in seminal vesicles and Leydig cells of the testes after hormone therapy. Conclusions Combined endocrine therapy results in histologically distinctive changes that can be found in both nonneoplastic and neoplastic prostate tissue. However, the drugs can not eradicate prostate cancer completely. Testis atrophy is the direct action of the therapy.