Appearance of High Endothelial Venule-Like Vessels in Benign Prostatic Hyperplasia is Associated With Lower Urinary tract Symptoms.
BACKGROUND
Chronic prostatic inflammation is implicated in the pathogenesis of benign prostatic hyperplasia (BPH)-associated lower urinary tract symptoms (LUTS). Previous studies evaluated the degree of chronic prostatic inflammation based on histological scores, which may contain subjective factors. We previously demonstrated that the number of high endothelial venule (HEV)-like vessels correlates positively with the magnitude of inflammation in chronic inflammatory gastrointestinal diseases. Here, we evaluated the degree of BPH-associated chronic prostate inflammation based on appearance of HEV-like vessels and determined whether the extent of inflammation correlated with LUTS severity, as evaluated by a urodynamic study.


METHODS
Eighty-six BPH tissue specimens derived from patients who had undergone urodynamic analysis were immunostained for CD34 and MECA-79 to determine HEV-like vessel number. Triple immunohistochemistry for either CD3 and CD20 or CD4 and CD8, together with MECA-79, was conducted to identify lymphocyte subsets associated with HEV-like vessels. We also determined whether the magnitude of chronic prostatic inflammation, as assessed by HEV-like vessel number, correlated with the degree of LUTS.


RESULTS
HEV-like vessels were induced in lymphoid aggregates seen frequently in BPH. The number of HEV-like vessels positively correlated not only with the magnitude of chronic prostatic inflammation but also with the degree of LUTS, particularly with symptoms associated with voiding function, which was measured objectively in a pressure flow study.


CONCLUSIONS
Chronic prostate inflammation may promote BPH and resulting voiding dysfunction. Assessment of the number of HEV-like vessels could be a surrogate for identifying the degree of chronic prostatic inflammation. Prostate 77:794-802, 2017. © 2017 Wiley Periodicals, Inc.
Department of Tumor Pathology, Faculty of Medical Sciences, University of Fukui, Eiheiji, Japan.|Department of Urology, Faculty of Medical Sciences, University of Fukui, Eiheiji, Japan.
So
S
Inamura
Department of Tumor Pathology, Faculty of Medical Sciences, University of Fukui, Eiheiji, Japan.|Department of Urology, Faculty of Medical Sciences, University of Fukui, Eiheiji, Japan.
Tomochika
T
Shinagawa
Department of Tumor Pathology, Faculty of Medical Sciences, University of Fukui, Eiheiji, Japan.
Hitomi
H
Hoshino
Department of Tumor Pathology, Faculty of Medical Sciences, University of Fukui, Eiheiji, Japan.
Yasuhiro
Y
Sakai
Division of Surgical Pathology, University of Fukui Hospital, Eiheiji, Japan.
Yoshiaki
Y
Imamura
Department of Urology, Faculty of Medical Sciences, University of Fukui, Eiheiji, Japan.
Osamu
O
Yokoyama
Department of Tumor Pathology, Faculty of Medical Sciences, University of Fukui, Eiheiji, Japan.
Motohiro
M
Kobayashi
D000368:Aged; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D007150:Immunohistochemistry; D059411:Lower Urinary Tract Symptoms / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000098:blood supply / Q000473:pathology; D011470:Prostatic Hyperplasia / Q000150:complications / Q000473:pathology / Q000503:physiopathology; D011472:Prostatitis / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D013223:Statistics as Topic; D014563:Urodynamics; D014699:Venules / Q000473:pathology*
bladder outlet obstruction; chronic prostatic inflammation; international prostatic symptom score; pressure flow study; urodynamic study