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Quantitative measurements of prostate capsule and gland density and their correlation to prostate size: possible clinical implications in prostate cancer

  • Urology - Original Paper
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Abstract

Purpose

To study histo-anatomical imaging features and possible association between prostate volume, capsule thickness and glandular density within the peripheral zone (PZ) of prostates of different sizes.

Methods

Patients were selected who had undergone radical prostatectomy. Specimen selection was based on two factors: first, easy reconstruction of prostate anatomy by the histological slides; and second, based on prostate size. Specimens were chosen with small (< 35 cc) and also with large size (> 80 cc). A total of 20 patients were selected. None of these patients had undergone previous treatment. Computer-based imaging for quantitative measurements of capsule thickness and glandular density within the PZ were performed. Multiple regression analysis was performed to determine the relationship between these measured parameters and the clinical characteristics of these patients.

Results

Multiple regression analysis revealed a strong, positive association between prostate size and average capsule thickness; on the contrary, we found a negative correlation between prostate volume and average glandular density. Fibrotic thickness of the capsule was associated with gland atrophy and decreased gland density within the PZ.

Conclusions

The results suggest that BPH may be associated with the development of fibrosis and gland atrophy within the peripheral zone. As 80% of prostate cancer originates from the glandular epithelium within the peripheral zone, this observed phenomenon may explain the inverse relationship between BPH and incidence of prostate cancer well documented in the literature.

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Authors and Affiliations

  1. Department of Urology, Texas Tech University Health Sciences Center, 3601 4th Street, MS7260, Lubbock, TX, 79430-7260, USA

    Pranav Sharma & Werner T. de Riese

  2. Department of Pathology, Texas Tech University Health Sciences Center, 3601 4th Street, MS7260, Lubbock, TX, 79430-7260, USA

    Lisa A. Smith

  3. Clinical Research Institute, Texas Tech University Health Sciences Center, 3601 4th Street, MS7260, Lubbock, TX, 79430-7260, USA

    Rohali Keesari & Hasan Al Mekdash

Authors
  1. Preston E. Weaver
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  2. Lisa A. Smith
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  3. Pranav Sharma
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  4. Rohali Keesari
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  6. Werner T. de Riese
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Contributions

WTR, PS, and PEW contributed to the study conception and design. Material preparation, data collection and analysis were performed by PW. The first draft of the manuscript was written by PW and reviewed by WT R. Statistical analysis was performed by RK and reviewed by HAM. PS commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Werner T. de Riese.

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Weaver, P.E., Smith, L.A., Sharma, P. et al. Quantitative measurements of prostate capsule and gland density and their correlation to prostate size: possible clinical implications in prostate cancer. Int Urol Nephrol 52, 1829–1837 (2020). https://doi.org/10.1007/s11255-020-02527-6

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  • DOI: https://doi.org/10.1007/s11255-020-02527-6

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