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

Woo Heon Cha; Tae Jung Jang; Kyung Seop Lee

doi:10.4111/kju.2008.49.3.242

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Cha, Jang, and Lee: Expression of Survivin and Bcl-2 in Benign Prostatic Hyperplasia Treated with a 5-alpha-reductase Inhibitor

Original Article

Korean J Urol 2008;49(3):242-247.

Published online: 17 January 2008

DOI: https://doi.org/10.4111/kju.2008.49.3.242

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

Woo Heon Cha, Tae Jung Jang¹, Kyung Seop Lee

^¹From the Departments of Urology and 1Pathology, College of Medicine, Dongguk University, Gyeongju, Korea

교신저자: 이경섭 동국대학교 의과대학 경주병원 비뇨기과 경북 경주시 석장동 1090-1번지 780-350, TEL: 054-770-8265, FAX: 054-771-0769, E-mail: ksleemd@dongguk.ac.kr

Revised 3 May 2007 Accepted 21 January 2008

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

A 5-alpha-reductase inhibitor (5αRI) 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 5αRI 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.

Keywords: Prostatic hyperplasia, Apoptosis, Survivin, Bcl-2

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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).

Table 1.

Baseline patients characteristics

	Group 1 (n=39)	Group 2 (n=31)	p-value^∗
Age (years)	73.03±7.02	74.71±5.99	0.283
Total prostate vol (ml)	45.51±8.78	37.23±3.36	＜0.001
Serum total PSA (ng/ml)	5.09±4.37	3.75±2.25	0.105

PSA: prostate-specific antigen.

^∗ : Statistical significance was done by Student's t-test.

Table 2.

Expressions of survivin, bcl-2 and ki-67 in specimen from both groups

	Group 1 (n=39)	Group 2 (n=31)	p-value
Survivin expression			＜0.001^∗
0 (%)	0 (0)	3 (9.7)
1 (%)	8 (20.6)	19 (61.3)
23(%)	21 (53.8)	9 (29.0)
3 (%)	10 (25.6)	0 (0)
Bcl-2 expression			0.001^∗
0 (%)	3 (7.7)	11 (35.4)
1 (%)	13 (33.3)	10 (32.3)
2 (%)	17 (43.6)	10 (32.3)
3 (%)	6 (15.4)	0 (0)
Ki-67	27.99±21.85	18.14±16.32	0.345^†

^∗ : Statistical significance was done by chi-square test,

^† : Statistical significance was done by Student's t-test.

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