Background: Benign prostate hyperplasia
(BPH) is the most common benign disease of human prostate. Currently BPH is
associated with unregulated proliferation of connective tissue and glandular
epithelium within the prostatic transition zone, and it has been described as
relevant characteristic of BPH—the increase of the total number of cells, and
not only an increase in cell size. To date, there are few studies on the
quantitative morphology of glandular tree of BPH compared with normal prostate.
The scarce investigations about this particular suggest that the glandular tree
branches and expands as the hyperplastic transformation occurs in the prostate.
Methods: To verify if this gland expansion and branching was similar to that
occurs in the normal prostate, this study deals with the estimation of several
stereological parameters as: labeling index for the proliferating cell nuclear
antigen to quantify the rate of proliferation of prostate epithelium, average thickness
of glandular epithelium, fraction of the volume occupied by the epithelium relative
to the total prostate volume, connectivity density of prostate glands, to
quantify the branching of prostate glands, and the average volume and the
volume-weighted mean glandular volume of prostate acini to assess the mean size
of the prostate acini and its variability. Results: All these estimates have
been performed in prostate specific antigen immunostained sections from
prostates of young men (controls) and in adenomectomy specimens from the
adenofibromiomatous variety of BPH. Conclusion: We conclude that the epithelial
proliferation is not the only factor intervening in the development of BPH. In
addition, a more prolonged survival of epithelial population, together with
some degree of hypertrophy of acini expressed by the increase of volume
fraction and thickness of acinar epithelium, is relevant in order to the growth
and expansion of the BPH glandular tree that shows more abundant and
heterogeneous acinar sprouts than in normal prostate.
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