Possible clinical implications of prostate capsule thickness and glandular epithelial cell density in benign prostate hyperplasia.

The negative correlation between BPH-size and incidence of prostate cancer (PCa) is well-documented in the literature, however the exact mechanism is not well-understood. The present study uses histo-anatomical imaging to study prostate volume in correlation to prostate capsule thickness, and glandular epithelial cell density within the peripheral zone (PZ).

Specimens were selected from radical prostatectomies ranging from 20 to 160 mL based on ease of anatomical reconstruction by the slides. A total of 60 patients were selected and underwent quantitative measurements of prostate capsule thickness and glandular epithelial density within the PZ using computer-based imaging software. Pearson's correlation and a stepwise multiple linear regression analysis was conducted to determine the relationship between these measured parameters and the clinical characteristic of these patients.

Pearson's correlation analysis revealed a strongly significant, negative correlation between prostate volume and glandular epithelial cell density (r(58)=-0.554, p<0.001), and a strongly significant, positive correlation between prostate volume and average capsule thickness (r(58)=0.462, p<0.001). Results of multiple regression analysis showed that average glandular epithelial cell density added statistically to this prediction (p<0.05).

The results suggest that growth of the transition zone in BPH causes increased fibrosis of the PZ, leading to atrophy and fibrosis of glandular cells. As 80% of PCa originates from the glandular epithelium within the PZ, this observed phenomenon may explain the inverse correlation between BPH and PCa that is well-documented in the literature.

Investigative and clinical urology. 2021 May 31 [Epub ahead of print]

Katherine G Holder, Bernardo Galvan, Andrew S Knight, Freedom Ha, Reagan Collins, Preston E Weaver, Luis Brandi, Werner T de Riese

Department of Urology, Texas Tech University Health Sciences Center, Lubbock, TX, USA., Department of Pathology, Texas Tech University Health Sciences Center, Lubbock, TX, USA., Department of Urology, Texas Tech University Health Sciences Center, Lubbock, TX, USA. .

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