The Study On Correlation Between The Expression Of TGF-β₁ And CTGF In Detrusor And Parameters Of Clinical Symptoms In BPH Patients

Objective:By detecting the expression of TGF-β₁(Transforming growth factor-β₁) and CTGF(Connective tissue growth factor) in detrusors and some clinical parameters in a group of benign prostatic hyperplasia patients,we try to investigate the correlation between the expression of TGF-β₁/CTGF and these parameters,and to study the relationship between the detrusor fibrosis and the clinical parameters of BPH,to pursue a new way of diagnosis and therapy of BPH.Materials and Methods:29 specimens of bladder wall of BPH patients were collected during the operation between june 2008 and february 2009 in Xiangya 3^rd Hospital.SP immunohistochemical method was used in studying the expression of TGF-β₁ and CTGF.The MOD(Mean optical density) of each specimen was analyzd by pathological autoanalyzer.Several clinical parameters were used to evaluate each BPH patient,such as the prostate volume,transition zone index(TZI),IPSS,maximum flow rate(Q_max),postvoid residual urine(PVR),prostate-specific antigen(PSA),the course of BPH.A specific value of each parameter were used to divide the 29 cases to two teams to analyse the correlation between the expression of TGF-β₁/CTGF and these parameters.Statistical analysises were performed with the use of SAS 9.1.3 software.Two specimens equal numbers were tested by T-test,and correlative analysis between two variable quantities were analyzed by Pearson-analysis,and for all statistieal tests,the level of significance was set at P<0.05.Result:(1)The TGF-β₁ MOD of detrusors in 16 cases of BPH patients whose prostate volume>50ml was not significantly different compared with the 13 cases whose prostate volume<50ml;The CTGF MOD in BPH patients with prostate volume>50ml was higher than that in the other team;(2)The TGF-β₁ and CTGF MOD in 20 cases of BPH patients whose TZI>0.65 were higher than that in the 9 cases whose TZI<0.65;(3)The TGF-β₁ and CTGF MOD of detrusors in 24 cases of higher IPSS team were not significantly different compared with the 5 cases with the lower IPSS team;(4)The TGF-β₁ and CTGF MOD of detrusors in 3 cases of BPH patients whose Q_max were in the level of 10～15ml/s were not significantly different compared with the 26 cases with the Q_max<10ml/s;(5) The TGF-β₁ and CTGF MOD in 6 cases of BPH patients whose PVR>50ml were significant higher than that in the 23 cases with PVR₅0ml;(6) The TGF-β₁ and CTGF MOD in 19 cases of BPH patients whose PSA>4ng/ml were obviously higher than that in the 10 cases with PSA≤4ng/ml;(7) The TGF-β₁ and CTGF MOD of detrusors in 22 cases whose course of BPH>2 years were not significantly different compared with the 13 cases whose course of BPH≤2 years; (8)By using Pearson-analysis on the expression of TGF-β₁ and CTGF in detrusors of BPH patients,we found that TGF-β₁ and CTGF have positive correlation in detrusors of BPH patients(r=0.761,P<0.01).Conclusions:(1) TGF-β₁ and CTGF have a strong correlation in the detrusor fibrosis caused by BPH,and it is possiblely because CTGF is an important downstream factor in the course of the fibrosis induced by TGF-β₁;(2) CTGF is a promising target of anti-fibrosis therapy;(3) TZI, PVR and PSA have a close relationship with detrusor fibrosis in the progression of BPH and will be useful clinical parameters in assessing the detrusor fibrosis caused by BPH;The volume of prostate,IPSS,Q_max and the course of BPH have no correlation with the fibrosis of detrusor. (4)TZI is a key clinical symptom parameter which has more value than the total volume of prostate.