良性前列腺增生最新研究进展
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摘要
良性前列腺增生(BPH)已经成为导致中老年男性排尿障碍的最为常见的良性疾病,是多种因素共同作用下的一种腺体细胞和间质细胞的增生性疾病,其发病率随年龄增长而增加。但其发病机制及病理基础仍存在很多争议。本文就BPH的解剖学、病理生理学、影像学特点以及假说机制的最新进展开展论述,以供后来更深入地研究。
Benign prostatic hyperplasia(BPH)has become the most common benign disease causing urination disorders in middle-aged and elderly men.It is a hyperplastic disease of glandular cells and stromal cells under the combined action of various factors.The incidence of BPH increases with age.However,its pathogenesis and pathological basis are still controversial.This article reviews the latest advances in the anatomy,pathophysiology,imaging and hypothesis mechanisms of BPH for further study.
Benign prostatic hyperplasia(BPH)has become the most common benign disease causing urination disorders in middle-aged and elderly men.It is a hyperplastic disease of glandular cells and stromal cells under the combined action of various factors.The incidence of BPH increases with age.However,its pathogenesis and pathological basis are still controversial.This article reviews the latest advances in the anatomy,pathophysiology,imaging and hypothesis mechanisms of BPH for further study.
引文
1那彦群,叶章群,孙颖浩.中国泌尿外科疾病诊断治疗指南(2014版)[M].北京:人民卫生出版社,2014:245-246.
2 McNeal J E.The zonal anatomy of the prostate[J].Prostate,1981,2(1):35-49.
3张贵成.良性前列腺增生的病理特征分析[J].实用心脑肺血管病杂志,2011,19(10):1760-1761.
4张化儒,杨国胜,邱晓拂.良性前列腺增生患者膀胱内前列腺突出度的研究进展[J].现代泌尿外科杂志,2018,23(8):636-640.
5 Hirayama K,Masui K,Hamada A,et al.Evaluation of Intravesical Prostatic Protrusion as a Predictor of Dutasteride-Resistant Lower Urinary Tract Symptoms/Benign Prostatic Enlargement With a High Likelihood of Surgical Intervention[J].Urology,2015,86(3):565-569.
6张小马,梁朝朝.良性前列腺增生的形态组织学及影像学研究进展[J].中华男科学杂志,2006,12(3):254-257.
7向玘.剪切波弹性成像对前列腺增生病理类型诊断的初步研究[C].中南大学,2014.
8 Ji Y,Ruan L,Ren W,et al.Stiffness of prostate gland measured by transrectal Real-Time shear wave elastography for detection of prostate cancer:A feasibility study[J].Br J Radiol,2019:20180970.
9郑入文,代宏亮,孙银屏,等.磁共振波谱成像及其在前列腺疾病中的应用[J].中国全科医学,2017,20(12):1500-1505.
10张继,田为中,王秀兰,等.磁共振扩散张量成像表观弥散系数、各向异性值在BPH组织类型鉴别中的应用[J].山东医药,2016,56(31):77-79.
11 La Vignera S,Condorelli R A,Russo G I,et al.Endocrine control of benign prostatic hyperplasia[J].Andrology,2016,4(3):404-411.
12 Wein A J,Kavoussi L R,Partin A W,et al.Campbell Walsh Urology[M].11th ed,Philadelphia:WB Saunders Elsevier,2016:2427-2435.
13 Liao C H,Li H Y,Chung S D,et al.Significant association between serum dihydrotestosterone level and prostate volume among Taiwanese men aged 40-79years[J].Aging Male,2012,15(1):28-33.
14杨博宇,夏术阶.前列腺移行带和外周带的增长调控与分子机制[J].中华泌尿外科杂志,2018,39(3):235-237.
15 Tang J,Yang J C,Zhang Y,et al.Does benign prostatic hyperplasia originate from the peripheral zone of the prostate?A preliminary study[J].BJU Int,2007,100(5):1091-1096.
16夏术阶,郝刚跃,文伟,等.正常前列腺组织中雄激素受体亚型表达[J].中华男科学杂志,2003,9(7):501-503,506.
17韩邦旻.前列腺组织中雄激素受体亚型产生机制、结构特点及其作用的研究[C].复旦大学,2006.
18 Song L,Shen W,Zhang H,et al.Differential expression of androgen,estrogen,and progesterone receptors in benign prostatic hyperplasia[J].Bosn J Basic Med Sci,2016,16(3):201-208.
19 Mizoguchi S,Mori K,Wang Z,et al.Effects of Estrogen ReceptorβStimulation in a Rat Model of Non-Bacterial Prostatic Inflammation[J].Prostate,2017,77(7):803-811.
20 Song W,Li D Y,Yuan H C,et al.Relationship between interleukin-8levels in expressed prostatic secretion and expressions of bFGF and Bcl-2in benign prostatic hyperplasia[J].Zhonghua Yi Xue Za Zhi,2016,96(2):104-107.
21阿不都沙拉木·阿布都瓦克,杨凡,宋光鲁.TGF-β1/Smads信号通路在泌尿系疾病中作用的研究进展[J].临床泌尿外科杂志,2018,33(4):331-333.
22 Park B K,Kim C W,Kwon J E,et al.Effects of Lespedeza Cuneata aqueous extract on testosterone-induced prostatic hyperplasia.[J]Pharm Biol,2019,57(1):90-98.
23 Tanimoto K.Genetics of the hypoxia-inducible factors in human cancers[J].Exp Cell Res,2017,356(2):166-172.
24 Wang L,Yang J R,Yang L Y,et al.Chronic inflammation in benign prostatic hyperplasia:implications for therapy[J].Med Hypotheses,2008,70(5):1021-1023.
25董伟.HIF-1α/VEGF在前列腺组织良性增生中的表达及作用[C].山东大学,2018.
26史立纲.前列腺增生合并慢性炎症的临床病理分析[J].临床研究,2018,26(4):52-54.
27 Chughtai B,Forde J C,Thomas D D,et al.Benign prostatic hyperplasia[J].Nat Rev Dis Primers,2016,2:16031.
28靳永胜,东冰,高继学,等.老年患者Ⅲ_B型前列腺炎的病理特点分析[J].临床泌尿外科杂志,2017,32(1):35-38.
29 Ellem S J,Wang H,Poutanen M,et al.Increased endogenous estrogen synthesis leads to the sequential induction of prostatic inflammation(prostatitis)and prostatic pre-malignancy[J].Am J Pathol,2009,175(3):1187-1199.
30 McPherson S J,Hussain S,Balanathan P,et al.Estrogen receptor-beta activated apoptosis in benign hyperplasia and cancer of the prostate is androgen independent and TNFalpha mediated[J].Proc Natl Acad Sci U S A,2010,107(7):3123-3128.
31 Brennen W N,Isaacs J T.Mesenchymal stem cells and the embryonic reawakening theory of BPH[J].Nat Rev Urol,2018,15(11):703-715.
32 Hennenberg M,Kuppermann P,Yu Q,et al.Inhibition of Prostate Smooth Muscle Contraction by Inhibitors of Polo-Like Kinases[J].Front Physiol,2018,9:734.
33 Chen P,Xu D Q,Xu S L,et al.Blebbistatin modulates prostatic cell growth and contrapctility through myosinⅡsignaling[J].Clin Sci(Lond),2018,132(20):2189-2205.
34 Yoshida T,Kinoshita H,Yoshida K,et al.Intravesical Prostatic Protrusion as a Predicting Factor for the Adverse Clinical Outcome in Patients With Symptomatic Benign Prostatic Enlargement Treated With Dutasteride[J].Urology,2016,91:154-157.
2 McNeal J E.The zonal anatomy of the prostate[J].Prostate,1981,2(1):35-49.
3张贵成.良性前列腺增生的病理特征分析[J].实用心脑肺血管病杂志,2011,19(10):1760-1761.
4张化儒,杨国胜,邱晓拂.良性前列腺增生患者膀胱内前列腺突出度的研究进展[J].现代泌尿外科杂志,2018,23(8):636-640.
5 Hirayama K,Masui K,Hamada A,et al.Evaluation of Intravesical Prostatic Protrusion as a Predictor of Dutasteride-Resistant Lower Urinary Tract Symptoms/Benign Prostatic Enlargement With a High Likelihood of Surgical Intervention[J].Urology,2015,86(3):565-569.
6张小马,梁朝朝.良性前列腺增生的形态组织学及影像学研究进展[J].中华男科学杂志,2006,12(3):254-257.
7向玘.剪切波弹性成像对前列腺增生病理类型诊断的初步研究[C].中南大学,2014.
8 Ji Y,Ruan L,Ren W,et al.Stiffness of prostate gland measured by transrectal Real-Time shear wave elastography for detection of prostate cancer:A feasibility study[J].Br J Radiol,2019:20180970.
9郑入文,代宏亮,孙银屏,等.磁共振波谱成像及其在前列腺疾病中的应用[J].中国全科医学,2017,20(12):1500-1505.
10张继,田为中,王秀兰,等.磁共振扩散张量成像表观弥散系数、各向异性值在BPH组织类型鉴别中的应用[J].山东医药,2016,56(31):77-79.
11 La Vignera S,Condorelli R A,Russo G I,et al.Endocrine control of benign prostatic hyperplasia[J].Andrology,2016,4(3):404-411.
12 Wein A J,Kavoussi L R,Partin A W,et al.Campbell Walsh Urology[M].11th ed,Philadelphia:WB Saunders Elsevier,2016:2427-2435.
13 Liao C H,Li H Y,Chung S D,et al.Significant association between serum dihydrotestosterone level and prostate volume among Taiwanese men aged 40-79years[J].Aging Male,2012,15(1):28-33.
14杨博宇,夏术阶.前列腺移行带和外周带的增长调控与分子机制[J].中华泌尿外科杂志,2018,39(3):235-237.
15 Tang J,Yang J C,Zhang Y,et al.Does benign prostatic hyperplasia originate from the peripheral zone of the prostate?A preliminary study[J].BJU Int,2007,100(5):1091-1096.
16夏术阶,郝刚跃,文伟,等.正常前列腺组织中雄激素受体亚型表达[J].中华男科学杂志,2003,9(7):501-503,506.
17韩邦旻.前列腺组织中雄激素受体亚型产生机制、结构特点及其作用的研究[C].复旦大学,2006.
18 Song L,Shen W,Zhang H,et al.Differential expression of androgen,estrogen,and progesterone receptors in benign prostatic hyperplasia[J].Bosn J Basic Med Sci,2016,16(3):201-208.
19 Mizoguchi S,Mori K,Wang Z,et al.Effects of Estrogen ReceptorβStimulation in a Rat Model of Non-Bacterial Prostatic Inflammation[J].Prostate,2017,77(7):803-811.
20 Song W,Li D Y,Yuan H C,et al.Relationship between interleukin-8levels in expressed prostatic secretion and expressions of bFGF and Bcl-2in benign prostatic hyperplasia[J].Zhonghua Yi Xue Za Zhi,2016,96(2):104-107.
21阿不都沙拉木·阿布都瓦克,杨凡,宋光鲁.TGF-β1/Smads信号通路在泌尿系疾病中作用的研究进展[J].临床泌尿外科杂志,2018,33(4):331-333.
22 Park B K,Kim C W,Kwon J E,et al.Effects of Lespedeza Cuneata aqueous extract on testosterone-induced prostatic hyperplasia.[J]Pharm Biol,2019,57(1):90-98.
23 Tanimoto K.Genetics of the hypoxia-inducible factors in human cancers[J].Exp Cell Res,2017,356(2):166-172.
24 Wang L,Yang J R,Yang L Y,et al.Chronic inflammation in benign prostatic hyperplasia:implications for therapy[J].Med Hypotheses,2008,70(5):1021-1023.
25董伟.HIF-1α/VEGF在前列腺组织良性增生中的表达及作用[C].山东大学,2018.
26史立纲.前列腺增生合并慢性炎症的临床病理分析[J].临床研究,2018,26(4):52-54.
27 Chughtai B,Forde J C,Thomas D D,et al.Benign prostatic hyperplasia[J].Nat Rev Dis Primers,2016,2:16031.
28靳永胜,东冰,高继学,等.老年患者Ⅲ_B型前列腺炎的病理特点分析[J].临床泌尿外科杂志,2017,32(1):35-38.
29 Ellem S J,Wang H,Poutanen M,et al.Increased endogenous estrogen synthesis leads to the sequential induction of prostatic inflammation(prostatitis)and prostatic pre-malignancy[J].Am J Pathol,2009,175(3):1187-1199.
30 McPherson S J,Hussain S,Balanathan P,et al.Estrogen receptor-beta activated apoptosis in benign hyperplasia and cancer of the prostate is androgen independent and TNFalpha mediated[J].Proc Natl Acad Sci U S A,2010,107(7):3123-3128.
31 Brennen W N,Isaacs J T.Mesenchymal stem cells and the embryonic reawakening theory of BPH[J].Nat Rev Urol,2018,15(11):703-715.
32 Hennenberg M,Kuppermann P,Yu Q,et al.Inhibition of Prostate Smooth Muscle Contraction by Inhibitors of Polo-Like Kinases[J].Front Physiol,2018,9:734.
33 Chen P,Xu D Q,Xu S L,et al.Blebbistatin modulates prostatic cell growth and contrapctility through myosinⅡsignaling[J].Clin Sci(Lond),2018,132(20):2189-2205.
34 Yoshida T,Kinoshita H,Yoshida K,et al.Intravesical Prostatic Protrusion as a Predicting Factor for the Adverse Clinical Outcome in Patients With Symptomatic Benign Prostatic Enlargement Treated With Dutasteride[J].Urology,2016,91:154-157.