经尿道前列腺电汽化术治疗前列腺增生症

应用经尿道前列腺电汽化术（ＴＶＰ）治疗良性前列腺增生症１２０例。手术时间平均５０分钟，出血量平均３０ｍｌ，术后不需要膀胱持续冲洗。留置导尿管时间平均２６．５小时，拔管后病人排尿通畅。前列腺症状评分从术前２０．９降至术后３个月的５．１，最大尿流率从术前１０．６ｍｌ／ｓ增加至术后３个月的１９．２ｍｌ／ｓ。ＴＶＰ具有疗效显著，并发症少、技术简单易掌握，价格较低和住院时间短等优点。     

Urethral stents in benign prostate hyperplasia

Management of lower urinary tract symptoms resulting from benign prostate hyperplasia in the high-risk surgical patient presents a unique challenge. Continuous urethral catheter drainage is associated with a significant decrease in the quality of life and a higher risk of urinary tract infections, bladder calculi, and hematuria. Urethral stents offer a theoretically attractive alternative to Foley catheter drainage. Newer designs allow selection of stent characteristics based on patient need. Urethral stents may be permanent or temporary. The history of urethral stent design and patient experience is reviewed in this article.     

Oxidative stress in benign prostate hyperplasia

To assess the status of oxidative stress in benign prostate hyperplasia, a very common disease in older men which constitutes a public health problem in Jijel, prostate tissues were obtained by transvesical adenomectomy from 10 men with benign prostate hyperplasia. We measured the cytosolic levels of malondialdehyde (MDA) and glutathione (GSH) and cytosolic enzyme activities of superoxide dismutase, catalase, glutathione peroxidase and glutathione S‐transferase. The development of benign prostate hyperplasia is accompanied by impaired oxidative status by increasing levels of MDA, depletion of GSH concentrations and a decrease in the activity of all the antioxidant enzymes studied. These results have allowed us to understand a part of the aetiology of benign prostate hyperplasia related to oxidative stress.     

Hedgehog signaling in prostate growth and benign prostate hyperplasia

Hedgehog (Hh) signaling has long been recognized for its role in axial patterning, mesenchymal-epithelial inductive signaling, and growth regulation during fetal development. In many embryonic tissues, Hh functions as a proliferative stimulus. Sonic hedgehog and Indian hedgehog are both expressed by the urothelium of the fetal prostate anlage, where they regulate cell proliferation and differentiation and play a role in prostate ductal budding. Whereas Hh signaling in mouse prostate diminishes during adolescence and is maintained at a low level in the adult, robust Hh signaling is commonly found in the adult human prostate. The reason(s) for robust Hh signaling in the adult human prostate and the actions of Hh signaling on growth and differentiation in the adult are not well understood. However, increased Hh signaling has been associated with prostate cancer and has been shown to accelerate prostate cancer growth. These observations suggest that inappropriate reawakening of this developmental growth signal may play a pivotal role in prostate neoplasia. This review examines the role of Hh signaling during early prostate growth and in its corollary actions during prostate disease, including benign prostate hyperplasia and prostate cancer. The use of Hh inhibitors as a therapeutic modality for androgen-independent treatment of prostate disease is also discussed.     

聚集素在前列腺正常、增生、癌组织中的表达及意义

目的　通过检测聚集素 (Clusterin)在前列腺正常、增生、癌变组织中的表达 ,探讨其与前列腺疾病发生发展的关系。　方法　采用免疫组织化学染色法检测 12例正常前列腺组织、15例良性前列腺增生组织 (BPH)、5 6例前列腺癌标本中Clusterin的表达水平。　结果　 3种组织中Clusterin的阳性及弱阳性表达率为 81% (67/83 ) ,其中前列腺正常、增生、癌组织中阳性及弱阳性表达率分别为17% (2 /12 )、73 % (11/15 )、96% (5 4/5 6)。前列腺癌组织中Clusterin表达水平明显高于前列腺正常 (t=8 82 ,P <0 0 1)及增生 (t =7 63 ,P <0 0 1)组织 ,且在癌组织中与肿瘤病理分级 (r =0 64 9,P <0 0 1)、临床分期 (r=0 60 9,P <0 0 1)呈正相关。　结论　Clusterin可能通过抗凋亡机制在前列腺癌的生物特性中发挥着重要的作用     

Caveolin-1:一种前列腺癌的标志物

前列腺癌严重威胁男性健康,早期诊断缺乏特异性生物标志物。caveolin-1(Cav-1)是一种功能基因,也是胞膜窖的重要外壳结构蛋白,与分子运输,细胞粘附和信号转导等多种细胞功能密切相关,在前列腺癌的发生发展中发挥重要作用。Cav-1可作为生物活性分子在前列腺癌微环境中促进肿瘤增殖和肿瘤血管生成。此外,Cav-1在前列腺癌原发灶及转移灶中均过度表达,尤其是转移灶。目前,Cav-1可在外周血被检测到,其表达水平对提高前列腺癌的诊断有提示意义,与预后相关。本文就Cav-1的结构、生物学特性以及与前列腺癌的相关性进行综述。     

IMPDH2蛋白与前列腺癌临床相关性分析

【摘要】〓目的〓研究IMPDH2在良性前列腺增生和前列腺癌中的表达,并分析其表达水平与临床病理特征的关系。方法〓收集临床手术切除的前列腺癌组织和前列腺增生,或者穿刺活检组织,所有组织均由病理学确诊。排除已做手术去势的前列腺组织。通过Western Blot检测IMPDH2在前列腺癌、前列腺增生组织中IMPDH2蛋白的表达情况|免疫组化检测前列腺癌、前列腺增生标本中IMPDH2的表达。分析IMPDH2基因的表达水平与临床病理特征的关系。结果〓前列腺癌患者组织中IMPDH2蛋白表达显著上调,IMPDH2蛋白表达上调与肿瘤临床分期、Gleason评分、转移相关。结论 IMPDH2在前列腺癌组织中表达上调,前列腺组织中检测IMPDH2可能有助于判断前列腺癌分化程度并评估预后。     

人前列腺癌组织和良性前列腺增生组织中p27kip1和CDKs的表达

目的　观察前列腺癌 (PCa)细胞中CDKs和p2 7kip1的蛋白表达。方法　采用蛋白印渍、电转移方法 (Westernblot)检测 15例人前列腺癌组织和 15例前列腺增生组织标本中CDKs和p2 7kip1的表达。结果　所有标本的非癌组织中均有较强的 p2 7kip1和CDK2 ,CDK4及CDK6蛋白表达。 15例人前列腺癌组织中与周边非癌组织比较有 11例 p2 7kip1蛋白表达明显降低 ,其中 5例术后发生转移的标本中有 4例 p2 7kip1蛋白表达降低。 15例前列腺增生组织标本增生组织和周边正常组织中 p2 7kip1蛋白表达强度相同。而所有标本中未见有CDKs (CDK2 ,CDK4,CDK6)蛋白表达在癌与周边非癌组织、增生组织与正常组织中的强度差别。结论　p2 7kip1蛋白的表达异常降低特异性见于人前列腺癌细胞中 ,和前列腺癌的发生有关。     

XAGE-1 b基因在良性前列腺增生症与前列腺癌中的表达及其意义

目的 观察XAGE-1b基因在良性前列腺增生症和前列腺癌中的表达,探讨其数值对良性前列腺增生症和前列腺癌各项指标的临床意义.方法 运用实时荧光定量聚合酶链反应(PCR)方法检测38例前列腺癌病理组织以及40例良性前列腺增生症组织XAGE-1b的基因表达水平.结果 XAGE-1b在前列腺癌组织中表达值为8.299 50±0.97116,在良性前列腺增生症组织中表达值为3.007 80±0.91600,差异有统计学意义(P＜0.05).XAGE-1b表达值随着Gleason评分、临床分期和肿瘤恶性程度升高而表达增强(P＜0.05).结论 XAGE-1b基因高表达值有助于前列腺癌的诊断和指导前列腺癌的恶性程度分期.

Abstract：

Objective To study the XAGE-1 b mRNA expression in prostate cancer (PCa) tissues and benign prostate hyperplasia (BPH) tissues,and explore the diagnostic values of XAGE-1 b mRNA expression level in PCa and BPH.Methods A sensitive,real-time quantitative polymerase chain reaction (PCR) assay was developed to compare the expression difference of XAGE-1b mRNA in PCa and BPH tissues,by testing 38 samples of PCa and 40 samples of BPH.Results The expression level of XAGE-1 b in PCa tissue was 8.299 50 ± 0.971 16,and 3.007 80 ± 0.916 00 in BPH tissue ( P＜0.05 ).The XAGE-1 b expression levels were increased with the increase of the Gleason score,clinical stage and malignant grade (P＜0.05).Conclusion The high expression of of XAGE-1 b mRNA can afford a reliable and helpful information for diagnosis of PCa and BPH,and PCa malignant grade.     

经尿道选择性绿激光汽化术与经尿道前列腺电切术治疗良性前列腺增生的Meta分析

目的:对比经尿道选择性绿激光前列腺汽化术(photoselective vaporization of prostate,PVP)与经尿道前列腺电切术(transurethral resection of prostate,TURP)治疗良性前列腺增生症(benign prostate hyperplasia,BPH)的安全性及有效性。方法:按Cochrane系统评价方法,计算机检索Cochrane library、Medline、Embase、CNKI、CBM、万方、维普等文献资料库;手工检索中文泌尿外科期刊的相关文献。收集对比PVP及TURP治疗BPH的随机对照试验,质量评价后采用RevMan 5.0软件进行Meta分析。结果:共纳入5个符合要求的RCT研究,共528例患者。Meta分析结果显示:(1)有效性方面:PVP及TURP治疗BPH,术后6个月国际前列腺症状评分、生活质量、最大尿流率和残余尿量指标差异均无统计学意义(P>0.05)。(2)安全性方面:与TURP相比,PVP手术时间较长[MD=28.97,95%CI(9.72,48.21)],术后留置导尿时间短[MD=-2.86,95%CI(-4.58,-1.13)],住院时间较短[MD=-2.32,95%CI(-2.79,-1.85)],术中输血较少[OR=0.08,95%CI(0.02,0.34)],术后尿道狭窄率无显著差异[OR=0.74,95%CI(0.27,2.07)]。结论:PVP与TURP均能显著改善轻、中度前列腺增生患者的症状,具有相似的临床疗效。与TURP相比,PVP操作更安全,术后留置导尿时间及住院时间更短;术后尿道狭窄发生率方面两种术式无显著差异。     

Ultrastructural aspects of human prostate in benign prostatic hyperplasia

The ultrastructural morphology of the prostate in benign prostatic hypertrophy has been studied with particular attention focused on features of prostatic secretory processes and the formation of "corpora amylacea." Morphological and cytochemical comparisons of prostatic secretory vacuoles and multivesicular bodies have been carried out, and the secretory mechanisms of the prostate have been further defined by scanning electron microscopy.     

不同前列腺组织中雄激素受体的表达研究

目的:研究雄激素受体(AR)在正常前列腺、良性前列腺增生(BPH)和前列腺癌(PCa)组织中的表达,探讨AR与BPH和PCa的关系。方法:采用实时定量PCR、免疫荧光和组织蛋白电泳方法,分析15例正常前列腺、20例BPH与40例PCa标本中AR的表达情况。结果:实时定量PCR和组织蛋白电泳检测BPH组织与正常前列腺组织中AR的表达量差异无统计学意义(P>0.05)。但免疫荧光检测发现BPH组织中AR蛋白表达量增高。3种方法检测PCa组织中AR表达量较正常前列腺组织和BPH组织增高(P<0.05)。高分化PCa的AR表达比低分化PCa高(P<0.05)。随着临床分期的增高,AR的表达降低(P<0.05),激素非依赖性前列腺癌(HRPC)组织中AR表达最低。结论:AR在PCa组织中的表达较正常前列腺和BPH组织中增高,AR的表达与PCa的分级、分期相关。     

良性前列腺增生症的微创治疗进展

良性前列腺增生症（BPH）是中老年男性泌尿生殖系统最常见的疾病之一,而外科手术治疗是治愈此疾病的唯一手段,传统的外科手术方法主要是开放前列腺摘除手术及经尿道前列腺切除术（TURP）,但因手术创伤较大及术中并发症较多,其在外科手术治疗中的主导地位不断受到各类新近微创治疗方法的挑战,其中一部分已成为治疗良性前列腺增生症的重要手段。本文就微创治疗技术在治疗良性前列腺增生症的发展作一综述,以供临床参考。     

Plasmakinetic prostate resection in the treatment of benign prostate hyperplasia: Results of 1-year follow up

AIM: In our randomized prospective study, we aimed to evaluate the efficiency of plasmakinetic resection of prostate (PKRP) by comparing the preoperative and postoperative results of the transurethral resection of prostate (TURP) and PKRP techniques which we administered in patients with benign prostate hyperplasia (BPH) in our clinic. METHODS: Of 57 patients for whom we thought an operative intervention was necessary, 30 cases in the first group had a TURP and 24 cases in the second group had a PKRP. International prostate symptom scores (I-PSS), uroflowmetry, measurement of residual urine amount and ultrasonography were performed for each patient both preoperatively and postoperatively (first month and first year). Operation times, urethral catheterization times, preoperative and postoperative Hb, Htc and serum Na values of the patients were compared and the complications of the groups were also compared. RESULTS: On first month and first year follow up between the groups, there was no significant statistical difference in I-PSS, maximum flow rate, average flow, residual urine and size of the prostate. The decrease in serum Na level was found to be significantly higher in the TURP group (P < 0.05). The operation times were not significantly different between the groups. While the postoperative catheterization time was 75.7 h in TURP group, it was found to be 42 h in PKRP group and it was clear that catheterization time was significantly shorter (P < 0001). CONCLUSION: It is obvious that PKRP is as efficient as TURP and it has a similar morbidity. In our opinion, PKRP makes a promising treatment for BPH with its advantages, such as early removal of postoperative urethral catheter, a shorter hospital stay and the absence of TUR syndrome risk.     

Analysis of the inflammatory network in benign prostate hyperplasia and prostate cancer

INTRODUCTION: The complexity of acute and chronic inflammatory processes may either lead to benign prostate hyperplasia (BPH) and/or prostate cancer. Obviously, various tissue cells are activated by chemokines via different chemotaxin receptors which then trigger subsequent processes in angiogenesis, cellular growth, and extravasation as well as neoplasia. METHODS: Using the surgically obtained tissue of patients (n = 36) with BPH or prostate carcinoma (PCA), we studied among others the expression of chemokines (Rantes, IL-8), chemotaxin receptors (CXCR-3 and -4, CCR-3, CCR-5), of matrixmetalloproteinases (MMP-2 and 9), of Toll-like (TL) receptors 1, 2, 3, 4, 5, 7, and 9 and of the inducible cyclooxygenase-2 (cox-2) by RT-PCR. Further support for the different properties of tissue from PCA was obtained using two different PCA cell lines (PC3 = androgen resistant cell) or LNCAP cells (androgen sensitive) with emphasis on IL-8, Il-6, and PGE(2) release. Cell lines were stimulated with either the tumor necrosis factor-alpha (TNF-alpha) and lipopolysacharide (LPS) over time. In addition to cytokine release, the quantification of mRNA by lightcycler for cox-2, IL-6, and IL-8 was performed on these cell lines. RESULTS: Remarkable differences in expression were obtained by RT-PCR when BPH tissue versus PCA was analyzed. Expression of CXCR-1 after incubation with LPS and TNF-alpha showed time-dependent differences for androgen-sensitive LNCAP as compared to androgen-resistant PC-3 cells. TNF-alpha incubation leads to a time-dependent induction of cox-2 expression unlike to activation with LPS. Differences with regard to cox-2, IL-6, and IL-8 expression were seen by quantitative lightcycler analysis. Significant differences were also observed when TL receptors 4, 5, 7, and 9 were analyzed which were significantly expressed in BPH- as compared to PCA-tissue. CONCLUSIONS: Our data clearly demonstrate that various inflammatory and cell biological cascades are involved which either lead to BPH or can be linked to the development of PCA. The exact cell biological mechanisms may provide novel therapeutic options in the treatment of both diseases.