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Histological changes of the peripheral zone in small and large prostates and possible clinical implications

Authors Guzman JA, Sharma P, Smith LA, Buie JD, de Riese WT

Received 18 September 2018

Accepted for publication 24 January 2019

Published 21 March 2019 Volume 2019:11 Pages 77—81

DOI https://doi.org/10.2147/RRU.S182781

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 3

Editor who approved publication: Dr Jan Colli


Jonathan A Guzman,1 Pranav Sharma,1 Lisa A Smith,1 John D Buie,2 Werner T de Riese1

1Department of Urology, Texas Tech University Health Sciences Center, Lubbock, TX, USA; 2Department of Pathology, Texas Tech University Health Sciences Center, Lubbock, TX, USA

Introduction: It is well documented in literature that most prostate carcinomas (PCa) arise in the peripheral zone (PZ). Additionally, an inverse relationship between prostate size and the incidence of PCa has been demonstrated in recent studies. However, little is known about gland distribution in the peripheral zone of larger prostates compared to smaller prostates. In this study, we examined the histo-anatomical gland distribution within the peripheral zone in small and large prostates and discuss possible clinical implications.
Methods: A semi-quantitative analysis of gland density and capsule thickness was performed using light microscopy on 10 large (≥80 g) prostate specimens and 10 small (
Results: Large prostates possessed a significantly lower mean gland count per field compared to small prostates (10.34±4.15, n=50 vs 18.00±5.41, n=50; t=8.16, df=49, P<0.001). Additionally, large prostates showed a significantly higher average capsule thickness in millimeters compared to small prostates (1.80 mm, ±1.12 mm, n=30 vs 0.90 mm, ±0.56, n=30; t=8.16, df=49, P<0.001).
Conclusion: The results demonstrate that prostate hypertrophy leads to both decreased gland density in the peripheral zone and increased capsule thickness, suggesting that growth-induced expansion of the prostate against its capsule leads to compression-induced atrophy and fibrosis of glandular tissue within the peripheral zone (PZ). A decrease in gland density within the PZ may have clinical implications shedding light, for instance, on the reduction in PCa incidence in patients with large prostates as compared to smaller prostates, a phenomenon well documented in the literature.

Keywords: prostate, adenocarcinoma, prostatic hyperplasia, peripheral zone



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