Korean J Urol.  2008 Mar;49(3):242-247. 10.4111/kju.2008.49.3.242.

Expression of Survivin and Bcl-2 in Benign Prostatic Hyperplasia Treated with a 5-alpha-reductase Inhibitor

• Cha WH
• Jang TJ
• Lee KS

• KMID: 1204626
• DOI: http://doi.org/10.4111/kju.2008.49.3.242

Abstract

PURPOSE: A 5-alpha-reductase inhibitor(5 alpha RI) can induce apoptosis and decrease the prostatic volume in patients with benign prostatic hyperplasia (BPH). In this study we assessed the expression of survivin and bcl-2 in the epithelium of BPH patients treated with finasteride.
MATERIALS AND METHODS
Group 1 consisted of 39 patients who underwent transurethral resection of the prostate(TURP) without medication and Group 2 consisted of 31 patients who underwent TURP and were treated with finasteride for more than three months. The mean age of both groups of patients was 73.03+/-7.02 years and 74.71+/-5.99 years, respectively. Immunohistochemical staining for survivin, bcl-2 and ki-67 was performed in prostatic tissues. The percentage of cells that expressed survivin and bcl-2 were classified into four categories based on the staining intensity. The expression of ki-67 in nuclei using 10 random cells per specimen was obtained. The relationship between 5alphaRI and the expression of survivin, bcl-2 and ki-67 was analyzed.
RESULTS
The total mean prostate volume of group 1 patients and group 2 patients was 45.51ml and 37.23ml, respectively (p<0.001) and the mean serum total prostate-specific antigen(PSA) level of group 1 patients and group 2 patients was 5.09ng/ml and 3.75ng/ml, respectively(p=0.105). Decreased expression of survivin and bcl-2 in specimens from group 2 patients was observed as compared to the level of expression in group 1 patients(p<0.001, p=0.001). Expression of ki-67 determined in samples from both groups was not significantly different(p=0.345).
CONCLUSIONS
We suggest that finasteride may induce apoptosis of prostatic epithelial cells in BPH patients by reducing the expression of survivin and bcl-2. These findings may indicate a reduction of prostatic volume.

Keyword

Prostatic hyperplasia; Apoptosis; Survivin; Bcl-2

Figure

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  Fig. 1. Immunohistochemical staining for survivin (A, B), bcl-2 (C, D) and ki-67 (E, F) in benign prostatic hyperplasia (BPH) patients given finasteride treatment (B, D, F) and for non-treated patients (A, C, E). In these tissues, survivin expression was distributed predominantly in the cytoplasm of epithelial cells (black arrow) and bcl-2 was expressed predominantly in the basal epithelium (white arrow). Comparing both groups, the immunoreactivities of survivin and bcl-2 in the group treated with finasteride (B, D) were decreased more than the immunoreactivities of the other group (A, C). The number of ki-67 labelled epithelial cells (black arrowhead) was similar between samples from the two groups (E, F) (x400).

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