Nodular hyperplasia of the prostate - Quantitative evaluation of secretorycell changes after treatment with finasteride

OBJECTIVE: To quantitatively evaluate the changes in the secretory cells in nodular hyperplasia of the prostate after treatment with finasteride. STUDY DESIGN: Secretory cell nuclear and nucleolar measurements were perfor med with an image analyzer in hematoxylin-and-eosin-stained sections of 20 untreated and 20 finasteride-treated cases of nodular hyperplasia. An immun operoxidase method teas used to stain the secretory cells with a monoclonal antibody-directed, anti-prostate specific antigen (PSA). The size of prost ates was determined by transrectal ultrasound. For both groups the serum PS A values were determined. RESULTS: After six months of treatment with finasteride, the prostates shra nk by approximately 20% with the therapeutic regimen (as determined by tran srectal ultrasound), whereas the serum PSA values decreased by 30% (before therapy, <4.00 ng/mL). The secretory cells appeared smaller than those from the untreated group of patients, and the cytoplasm staining of the PSA mar ker was slightly diminished. Karyometric analyses showed that the nuclear a nd nucleolar size were smaller in comparison with the controls. In particul ar, the mean nuclear and nucleolar area in the treated group were, respecti vely, 34.12 and 1.424 mu m(2), whereas in the untreated group the values we re 40.46 and 2.262. CONCLUSION Reduced androgen stimulation after treatment with finasteride in duces involution of secretory cells. This may be responsible for the decrea se in the serum PSA level and may contribute to the reduction in prostate s ize.