老年人前列腺慢性炎症与前列腺癌及前列腺增生的相关性研究

摘要

目的 观察老年人前列腺标本中组织学慢性炎症的病理学表现,探讨其与前列腺癌及前列腺增生的相关性.方法 回顾手术切除的前列腺标本,观察不同区域的组织病理学特征,对部分病例的炎症细胞进行免疫组织化学标记CD3、CD20、CD4、CD8、CD117及CD138;标记炎症相关因子核因子-κB、环氧化酶-2、肿瘤坏死因子-α及诱异型一氧化氮合酶.结果 176例患者中,前列腺癌100例,前列腺增生76例,均检出不同程度的慢性炎症,其中轻度慢性炎为71例(40.3％),中度慢性炎为80例(45.5％),重度慢性炎为25例(14.2％).炎症细胞以CD3标记阳性的淋巴细胞为主,伴有少量的单核细胞及肥大细胞.炎症程度与前列腺癌及其分化程度、前列腺增生、局灶性萎缩及其类型、高分级上皮内瘤无相关性(均P＞0.05).COX-2的表达与炎症程度相关(P＜0.05).结论 组织学的慢性炎症在老年人前列腺标本中常见,炎症程度与前列腺癌及前列腺增生无关.炎症程度与COX-2表达水平呈正相关,可能与氧化应激诱导COX-2路径活化相关.%Objective To investigate the pathological features of chronic inflammation in prostatic specimens,and study the correlation of chronic prostatic inflammation with prostate cancer and hyperplasia of prostate in the elderly.Methods The histopathologic features of prostatic specimens which were taken during prostatectomy were retrospectively observed.The inflammatory cells in partial cases were labeled by immunohistochemical markers such as CD3,CD20,CD4,CD8,CD117 and CD138,and by inflammation related factors such as nuclear factor(NF)-κB,(COX-2),tumor necrosis factor-α(TNF-α)and inducible nitric oxide synthase (iNOS).Results The chronic prostatic inflammation of different extent were found in 100 patients with prostate cancer and 76 patients with benign prostatic hyperplasia,among them 71 cases (40.3 ％) had mild chronic prostatic inflammation,80 cases (45.5 ％) had moderate chronic prostatic inflammation,25 cases (14.2 ％) had severe chronic prostatic inflammation.Inflammatory cells mainly were CD3-labeled lymphocytes,accompanied by a small amount of mononuclear cells and mast cells.Chronic prostatic inflammation was not correlated with prostatic carcinoma and its differentiation degree,benign prostatic hyperplasia,focal atrophy and its subtypes,and high grade prostatic intraepithelial neoplasia (all P＞ 0.05).There was correlation between chronic prostatic inflammation and expression of COX-2 (P＜ 0.05).Conclusions The histological chronic inflammation is common in the prostate specimens in elderly men.There are no direct correlations of prostatic inflammation with prostatic carcinomas and benign prostatic hyperplasia.Prostatic inflammation is positively correlated with the expression of COX 2,which may be associated with the activation of COX-2 pathway induced by oxidative stress.