PERCENTAGE AREA DENSITY OF EPITHELIAL AND MESENCHYMAL COMPONENTS IN BENIGN PROSTATIC HYPERPLASIA - COMPARISON OF RESULTS BETWEEN SINGLE BIOPSY, MULTIPLE BIOPSIES AND MULTIPLE TISSUE SPECIMENS

Objective To determine whether histological analysis of six multiple r andom biopsies of the gland or analysis of only one biopsy provides a good estimate of the different components of the hyperplastic gland co mpared with the results obtained from tissue specimens (reference valu es). Materials and methods The various components of prostate tissue o btained from 30 men undergoing suprapubic adenomectomy were investigat ed. The histological analysis was performed on multiple tissue specime ns reflecting adenoma (reference values) and on one and six biopsies p erformed at random on the enucleated material of the hyperplastic glan d, Immunohisto chemistry using anti-actin as a label of smooth muscle and specific histological staining coupled with computer-assisted quan titative morphometric analysis was used to ascertain the histological composition of the prostate. Results The mean (+/-SD) area densities o btained from tissue specimens were 34.1 +/- 5%, 32.4 +/- 6.9%, 17.6 +/ - 4.5% and 15.9 +/- 5.5% of smooth muscular and fibrous tissue, and ep ithelium and glandular lumen, respectively, The mean ratio of stromal to epithelial hyperplasia averaged 4.05 +/- 1.73. Both one and six bio psies gave a good estimate of fibrous tissue and glandular epithelium, but the percentage of smooth muscle was overestimated and the percent age of glandular lumen was underestimated. There was a significant rel ation between the prostate area densities of glandular epithelium (r = -0.41, P < 0.05), the percentage area density of prostate smooth musc le (r = 0.43, P < O.O5), and the weight of enucleated adenoma, No corr elation was found with prostate-specific antigen (PSA). Conclusion It seems feasible to propose medical treatment of benign prostatic hyperp lasia (BPH) based on the histological composition of the prostate glan d. One biopsy, reflecting in good proportions the nature of the adenom a, would be used to provide insight into the pathogenesis and therapy of BPH.