Growth fractions in human prostatic carcinoma determined by Ki-67 immunostaining.

Until recently, [3H]-thymidine incorporation, DNA analysis by flow cytometry, and cell doubling times have been the main methods of studying tumour cell kinetics. All these techniques are laborious, expensive, and difficult to perform in a routine diagnostic laboratory. This study examined fresh frozen sections from 31 prostatic biopsy specimens with the hybridoma antibody Ki-67, a marker of proliferating cells, using a modified avidin-biotin-peroxidase complex technique. The percentage of glandular cells decorated by this antibody, representing the growth fraction, was determined for both benign and malignant samples. Benign prostatic glands showed an average Ki-67 score of 4 per cent, significantly less than the 16.3 per cent mean growth fraction found in prostatic carcinomas. There was a significant correlation between the tumour growth fraction as assessed by Ki-67 staining, and the histological grade. A positive correlation was also found between the Ki-67 score and the intensity of staining, and a definite trend was noted between the Ki-67 score and the tumour clinical stage. Ki-67 promises to be a useful marker in determining the prognosis of prostatic cancer.

Sexual dysfunction after prostatectomy.

One of the major and disconcerting complications of prostatectomy is impotence. Several studies have reported only a small reduction in potency rates following prostatectomy but have not examined the effect of surgery per se on a group of men in whom one could expect a significant incidence of reduced potency. In order to rectify this defect, a prospective study was undertaken to assess the effect of transurethral resection of the prostate (TURP) and other general surgical procedures on two age-matched populations. In all cases potency and ejaculatory function and frequency of intercourse were assessed pre- and post-operatively. Potency was retained in 86% of men undergoing TURP and in all of the men undergoing general surgical procedures (p less than 0.01). Of those men who indicated that they were capable of having sexual intercourse prior to operation, 88% were unaffected by TURP. In the general surgical group 97% were unaffected. Thus it would appear that TURP has a significant effect on sexual function which cannot be accounted for by the stress of surgery or the age of the population undergoing operation.