The relationship between histologic content and clinical variables in benign prostatic hypertrophy / 대한비뇨기과학회지

ABSTRACT

To maximize the therapeutic efficacy of non-surgical management in patients with benign prostatic hypertrophy (BPH). the prediction of major histologic type in each patient before treatment would be very important. In order to determine if such patients might be identified prospectively we investigated the relationship between clinical variables such as age, prostate weight (PWt). symptom score. clinical point, total (TAP) and prostatic acid phosphatase (PAP) and volume density of prostate glandular lumen (PGL) determined by computer interactive image analysis. Histologic specimens were obtained on 17 patients who underwent open prostatectomy with BPH. The mean age was 71 years (range 55-84). mean PGL 18.6 % (range 7.9-35.7). mean PWt 47 gram (range 14-100). mean symptom score 16 (range 9-23), clinical point 22 (range 12-42). TAP 8.8 unit/L (range 6.5-13.3) and PAP 1.9 unit/L (range 0.5-4.8). Multivariate regression analysis between these variables and univariate regression analysis according to PGL and prostate weight revealed as no significant relationships and there also were no significance between two groups divided by median value of PGL (14.8%) or PWt (38 gram.) except the inverted correlation between weight of prostate and symptom score (p<0.05). But univariate regression analysis between PGL and PWt in 12 patients with less than 70 grams in weight revealed significant relationship PGL=0.49S PWt+3.32 (r=0.81, p=0.0015). We could divide another 5 patients into two different groups according to the PGL mean 10.9 % (range 9.3-13.7) in 3 patients and 33.2 % (range 29.0-34.8) in 2 patients respectively. The predominant histologic feature in low PGL, heavy PWt group represented uniformly muscular hyperplasia. In conclusion, we could not find any significant correlations between PGL and other clinical variables used in the study. Even there was a statistical significance between PGL and PWt under the limited condition, but we should not overlook the possibility that the difference in PGL upto three folds can be exist in patients with similar PWt.