背景:关于免疫组织化学检测到的前列腺标记蛋白在与女性尿道相关的腺体中的分布,可能与固定时的组织完整性有关。
目的:在这项研究中,我们使用来自女性患者快速尸检的组织来确定表达前列腺特异性抗原(PSA)和前列腺特异性酸性磷酸酶(PSAP)的腺体结构在女性尿道和周围组织中的分布。包括阴道前壁(AVW)。
方法:分析了包含整个尿道和相邻AVW的7个供体的组织块。这些组织样品在死亡后4-12小时内固定,并分成石蜡包埋的5mm横向切片。对从每个切片上切下的切片进行PSA或PSAP免疫标记,并将相邻切片用苏木精和曙红染色。通过光学显微镜检查切片并使用QuPath软件进行分析。
方法:在所有供体的组织中,表达PSA和/或PSAP的腺体结构位于尿道壁内,并沿其整个长度存在。
结果:在来自所有捐献者的尿道近半部,表达PSAP的小腺体,但不是PSA,观察到邻近并排空到管腔中。在7个捐献者中的5个的尿道的远端一半,由腺上皮内衬的肾小管泡状结构表达PSA和PSAP。此外,来自所有供体的尿道远半部具有多层过渡上皮的结构表面的柱状细胞表达PSAP。在尿道周围组织中未发现表达PSA或PSAP的腺体,包括AVW。
结论:对女性患者中表达前列腺蛋白的尿道腺体的分布有更多的了解是重要的,因为据报道这些腺体有助于女性的性反应和尿道病理,包括尿道囊肿,憩室,和腺癌。
■本研究的优势包括使用快速尸检以最大程度地减少蛋白质降解和自溶,并准备大组织切片,以证明尿道腔周围所有组织内的精确解剖关系。限制包括样本大小和所有供体都患有晚期恶性肿瘤并且已经经历过可能具有未知组织效应的先前治疗。
结论:在所有供体的组织中观察到表达前列腺特异性蛋白的近端和远端腺体,这些腺体仅位于尿道壁内。
BACKGROUND: There are varying reports of immunohistochemically detected prostatic marker protein distribution in glands associated with the female urethra that may be related to tissue integrity at the time of fixation.
OBJECTIVE: In this study we used tissue derived from rapid autopsies of female patients to determine the distribution of glandular structures expressing prostate-specific antigen (PSA) and prostate-specific acid phosphatase (PSAP) along the female urethra and in surrounding tissues, including the anterior vaginal wall (AVW).
METHODS: Tissue blocks from 7 donors that contained the entire urethra and adjacent AVW were analyzed. These tissue samples were fixed within 4-12 hours of death and divided into 5-mm transverse slices that were paraffin embedded. Sections cut from each slice were immunolabeled for PSA or PSAP and a neighboring section was stained with hematoxylin and eosin. The sections were reviewed by light microscopy and analyzed using QuPath software.
METHODS: In tissue from all donors, glandular structures expressing PSA and/or PSAP were located within the wall of the urethra and were present along its whole length.
RESULTS: In the proximal half of the urethra from all donors, small glands expressing PSAP, but not PSA, were observed adjacent to the and emptying into the lumen. In the distal half of the urethra from 5 of the 7 donors, tubuloacinar structures lined by a glandular epithelium expressed both PSA and PSAP. In addition, columnar cells at the surface of structures with a multilayered transitional epithelium in the distal half of the urethra from all donors expressed PSAP. No glands expressing PSA or PSAP were found in tissues surrounding the urethra, including the AVW.
CONCLUSIONS: Greater understanding of the distribution of urethral glands expressing prostatic proteins in female patients is important because these glands are reported to contribute to the female sexual response and to urethral pathology, including urethral cysts, diverticula, and adenocarcinoma.
UNASSIGNED: Strengths of the present study include the use of rapid autopsy to minimize protein degradation and autolysis, and the preparation of large tissue sections to demonstrate precise anatomical relations within all the tissues surrounding the urethral lumen. Limitations include the sample size and that all donors had advanced malignancy and had undergone previous therapy which may have had unknown tissue effects.
CONCLUSIONS: Proximal and distal glands expressing prostate-specific proteins were observed in tissue from all donors, and these glands were located only within the wall of the urethra.