Apoptosis and nuclear shapes in benign prostate hyperplasia and prostate adenocarcinoma: Comparison with and relation to Gleason score

Abstract

Purpose: To compare differences in the number of apoptotic bodies and nuclear shapes (size and roundness) between untreated benign prostate hyperplasia (BPH) and untreated advanced prostate adenocarcinoma (PCA) and to elucidate differences in apoptosis number and nuclear shapes with increasing malignant potentiality, by Gleason score, in PCA. Methods: A retrospective study was conducted on 40 patients with BPH and 12 patients with PCA I (Gleason score 2-4), 14 patients with PCA II (Gleason score 5-7) and 14 patients with PCA III (Gleason score 8-10).The frequency of apoptotic bodies (mean percentage calculated from 200 cells/high-power field over 10 fields) was examined on immunostain. Nuclear shapes were determined by an automatic image analyzer. Over 100 hyperplastic cells or cancer cells were detected by the image analyzer. Results:The mean number of apoptotic bodies in BPH and PCA I were not significantly different, but patients with PCA II and PCA III showed significantly higher numbers of apoptotic bodies than patients with BPH. Patients with PCA III had significantly more apoptotic bodies than patients with PCA I. Benign prostate hyperplasia nuclei had the smallest mean nuclear area and the largest mean nuclear peripheral ellipse among the four groups. The study showed that PCA I, II, III nuclei had significantly larger areas and a less circular shape than nuclei from patients with BPH. Nuclei from patients with PCA I were smaller in size and rounder than nuclei from patients with PCA III. Conclusions:The present study clearly shows the presence of apoptosis in BPH and PCA and shows an increasing number of apoptotic bodies with higher cellular malignancy. The nuclear shapes in PCA were more irregular and larger in size with increasing cellular malignancy. As expected, nuclei in BPH were smaller in size and rounder than those of cancer nuclei.

Sex steroid receptor expression and localization in benign prostatic hyperplasia varies with tissue compartment

“…Our finding of 32.50 μm 2 as the mean epithelial nuclear size in BPH is consistent with other reports of 25.4 μm 2 (Montironi et al, 1993) and 33.87 μm 2 (Choi et al, 1999). Treatment of prostate adenocarcinoma with androgen deprivation therapy results in small, dense nuclei relative to the large nuclei observed in untreated prostate adenocarcinoma (Dey, 2010).…”

Nuclear phenotypes and morphometry of human secretory prostate cells: a comparative study of benign and malignant lesions in Brazilian patients

“…The findings for the cases of AC agreed with the increase in nuclear size in malignant prostate lesions in patients from other parts of the world, including Sweden, South Korea and Spain (WANG et al 1992;CHOI et al 1999;LOPEZ-BELTRAN et al 2000). The ability of morphometry to discriminate between BPH and control cells (Ct) is potentially relevant since in the same patient these two types of tissue cannot be distinguished by their apoptotic responses (TABOGA 1999).…”

“…This observation which differs from that of CHOI et al (1999) but agrees with PETEIN et al (1996), probably reflects the existence of large intratumor heterogeneity present in the cases analyzed. Karyometry has previously revealed heterogeneity in secretory cell nuclei in high-grade PIN lesions (BARTELS et al ).…”

“…The cell nuclei in AC of increasing malignancy, as graded by the GLEASON score (1977), have larger areas and a less circular shape compared to BPH nuclei (CHOI et al 1999). Although PETEIN et al (1996) considered morphonuclear-related variables detected by image cytometry to be weak discriminators of the various grades of the Gleason classification system, particularly between high (Gleason 4 and 5) and low (Gleason 1, 2, and 3) scores, AC nuclei are apparently more irregular in shape and larger in size with increasing malignancy based on the Gleason score (CHOI et al 1999). A nuclear roundness factor has been recommended for assessing the prognosis of patients with AC (MOHLER et al 1988a, b).…”

Human prostate cancer risk factors

“…The percentage of apoptotic bodies was progressively higher in low‐grade PIN, high‐grade PIN, and adenocarcinoma compared with the percentage in BPH (0.68%, 0.75%, and 0.92–2.10% vs. 0.26%, respectively). There also was a positive correlation between the number of apoptotic bodies and increasing Gleason score 1017, 1018. There was no apparent correlation between the numbers of mitotic figures and apoptotic bodies.…”