A Study On The Correlation Of Finasteride Inhibits BPH Angiogenesis By Regulating HIF-1α Signal Pathway

Objective:To explore the mechanism of action of oral administration of Finasteride before operation on reducing bleeding during operation, and to direct the best course of treatment for patients with benign prostatic hyperplasia before and after transurethral resection of prostate. Methods:Collecting Department of Urology of the first hospital of Shanxi Medical University in 2015, between April to September 2015 clinical diagnosis of 90 cases of patients with benign prostatic hyperplasia(BPH). Among them taking Finasteride group were 60 people, the experimental group A(preoperative medication 2-11 days, 5mg, Qd, PO) were 30 people, the experimental group B(preoperative medication 14-30 days, 5mg, Qd, PO) were 30 people, the control group(without preoperative finasteride) were 30 people. Determined the trace free hemoglobin concentration in washing liquid. The blood loss of TURP in each group was determined with the preoperative hemoglobin concentration calculation. To determine the weight of prostate tissue in each group, then to determine the amount of bleeding per gram of tissue removed during surgery. PCR technique was used to determine the expression level of HIF-1α and VEGF in the tissues of each group. Immunohistochemical method was used to detect the expression of HIF-1 and VEGF in the tissues of each group. Results:A total of 62 patients were included in the study. There were 20 cases in the control group, the average age was 71 years old. There were 22 cases in the experimental group A, the average age was 69.3 years old. There were 20 cases in the experimental group B, the average age was 70.5 years old.The three groups of patients with resected tissue weight were 17.56±3.37g、18.45±4.98g、23.83±2.37 g, total bleeding were 31.71±4.38ml、27.48±8.34ml、32.00±6.54 ml, respectively, the amount of bleeding was 2.10±0.47ml、1.57±0.30ml、1.37±0.20 ml. After the comparison between each two groups, experimental group A per gram of bleeding was less than the control group, experimental group B per gram of the amount of bleeding was less than the control group, experimental group B per gram of bleeding in the experimental group A decreased without significant difference.The relative expression levels of HIF-1α in the three groups were 0.946±0.183、0.440±0.111、0.396±0.087, respectively. There were statistically significant differences between the three groups. After the comparison between each two groups: There were statistical differences between the control group and the experimental group A. There were statistical differences between the control group and the experimental group B. There was no statistical difference between the experimental group A and the experimental group B. The relative expression levels of VEGF in the three groups were 1.121±0.225、0.536±0.158 、0.374 ±0.117, respectively, and there were statistically significant differences among the three groups. After the comparison between each two groups: There were statistical differences between the control group and the experimental group A. There were statistical differences between the control group and the experimental group B. There were statistical differences between the experimental group A and the experimental group B.After staining the prostate gland tissue of each group wer e stained by immunohistochemistry technique. HIF-1α positive expression rate was 75% in the control group, the positive expression of HIF-1α rate of experimental group A was 8.3%, the positive expression of HIF-1α rate in the experimental group B was 8.3%. Chi square value is 23.266, P<0.001, the difference has statistical significance. After the comparison between each two groups: HIF-1α positive expression levels in the control group than in the experimental group HIF-1α; A positive expression levels in the control group was higher than in the experimental group B; HIF-1α positive expression levels between the experimental group A and the experimental group B was no statistically significant difference. The positive expression of VEGF in the three groups were 100%, Chi square value is 81.504, P<0.001, the difference was statistically significant. After the comparison between each two groups: The positive expression of VEGF in the control group was higher than that in the experimental group A. The positive e xpression of VEGF in the control group was higher than that in the experimental group B. The positive expression of VEGF in the experimental group A was higher than that in the experimental group B. Conclusion:1. With the extension of time of taking medicine, 1-2 weeks of medication in patients with per gram of excised tissue bleeding significantly reduced, 3-4 weeks of medication in patients with bleeding decrease but no further decreased significantly, it is suggested that the finasteride inhibited the benign prostatic hyperplasia angiogenesis; 2.HIF-1 alpha and VEGF protein expression were decreased with the prolonging of time, and the expression of HIF-1 and VEGF protein was positively correlated, suggesting that hypoxia inducible factor pathway may be one of the mechanisms of angiogenesis in benign prostatic hyperplasia; 3.The positive expression and expression level of HIF-1α and VEGF protein in patients with medication were significantly lower than that in the patients without medication, indicating that finasteride inhibits BPH angiogenesis by regulating HIF-1α signal pathway; 4. Per gram of resected tissue bleeding volume in the patients with medication were less than those in the patients without medication, preoperative oral finasteride 1-2 weeks can reduce bleeding during TURP, it is recommended in patients with preoperative medication.