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Lamb AD, Qadan M, Roberts S, et al. CD4+ and CD8+ T-lymphocyte scores cannot reliably predict progression in patients with benign prostatic hyperplasia. BJU Int. 2011;108(2):E43-50doi: 10.1111/j.1464-410X.2010.09787.x.
Lamb, A. D., Qadan, M., Roberts, S., Timlin, H., Vowler, S. L., Campbell, F. M., Grigor, K., Bartlett, J. M., & McNeill, S. A. (2011). CD4+ and CD8+ T-lymphocyte scores cannot reliably predict progression in patients with benign prostatic hyperplasia. BJU international, 108(2), E43-50. https://doi.org/10.1111/j.1464-410X.2010.09787.x
Lamb, Alastair D, et al. "CD4+ and CD8+ T-lymphocyte scores cannot reliably predict progression in patients with benign prostatic hyperplasia." BJU international vol. 108,2 (2011): E43-50. doi: https://doi.org/10.1111/j.1464-410X.2010.09787.x
Lamb AD, Qadan M, Roberts S, Timlin H, Vowler SL, Campbell FM, Grigor K, Bartlett JM, McNeill SA. CD4+ and CD8+ T-lymphocyte scores cannot reliably predict progression in patients with benign prostatic hyperplasia. BJU Int. 2011 Jul;108(2):E43-50. doi: 10.1111/j.1464-410X.2010.09787.x. Epub 2011 Apr 01. PMID: 21457430.
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BJU Int. 2011 Jul;108(2):E43-50. doi: 10.1111/j.1464-410X.2010.09787.x. Epub 2011 Apr 01.

CD4+ and CD8+ T-lymphocyte scores cannot reliably predict progression in patients with benign prostatic hyperplasia.

BJU international

Alastair D Lamb, Motaz Qadan, Simon Roberts, Hannah Timlin, Sarah L Vowler, Fiona M Campbell, Ken Grigor, John M S Bartlett, S Alan McNeill

Affiliations

  1. Department of Urology, University of Edinburgh, Edinburgh, UK. [email protected]

PMID: 21457430 DOI: 10.1111/j.1464-410X.2010.09787.x

Abstract

OBJECTIVE: To determine whether the density of CD4(+) and CD8(+) T-lymphocytes in a transrectal ultrasonography (TRUS) biopsy of the prostate can be used to predict the progression of lower urinary tract symptoms (LUTS) in benign prostatic hyperplasia (BPH).

PATIENTS AND METHODS: In total, 100 patients were randomly selected from a pool of patients with histologically proven, benign TRUS biopsy specimens. There were seven full years of follow-up available. Clinical data were recorded, including prostate volume, International Prostate Symptom Score (IPSS), prostate-specific antigen, urine flow rate, postvoid residual urine volume and previous prostate surgery. Markers of disease progression included the subsequent development of acute urinary retention (AUR), ≥4 point rise in IPSS, prescription of medical therapy (α-blocker or 5-α-reductase inhibitor) and bladder outlet surgery. Four patients' specimens were unsuitable for analysis. Biopsy sections from 96 patients were immunohistochemically stained for the presence of CD4(+) and CD8(+) T-lymphocytes and the density of infiltrate was assessed using random field sampling and point counting.

RESULTS: Some 29% of patients (28/96) did not have BPH at the time of biopsy. Of all patients, 41% (39/96) progressed, 10% of whom (4/39) did not have BPH at the time of biopsy. A further 10% (10/96) developed AUR, 7% (7/96) had a ≥4 point rise in IPSS, 33% (32/96) required medical therapy for BPH and 11% (11/96) required bladder outlet surgery. There was low correlation between CD4(+) and CD8(+) densities in paired sections. CD4(+) and CD8(+) densities did not provide any significant predictive function in the progression of BPH, nor was their any predictive association noted between CD4(+) and CD8(+) scores and the development of prostate cancer. Sub-analysis did show that a threshold mean of ≥1.35 CD8(+) cells per field predicted progression to AUR with a sensitivity of 60% (95% confidence interval, CI, 26.2-87.8), specificity of 73.3% (95% CI 62.6-82.2) but a positive predictive value of 20.6% (95% CI 8.0-39.7). CD4(+) infiltrate density suggested a trend to general progression but without statistical significance.

CONCLUSION: The present study, despite certain trends, shows no evidence for an association between CD4(+) and CD8(+) T-lymphocytes and the progression of LUTS in BPH.

© 2010 THE AUTHORS. BJU INTERNATIONAL © 2010 BJU INTERNATIONAL.

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