[Apoptosis in pathologic prostatic processes]

Numerous studies have demonstrated the apoptotic index to be significantly higher in benign prostatic lesions than in PIN and adenocarcinoma. Furthermore, a lower apoptotic index in epithelial cell populations has been shown to correlate with decreased immunoreactivity for prostate specific antigen that may be seen in higher Gleason grade tumors. It is suggested that the loss of function of some apoptotic regulators contributes to the development of PIN and prostatic adenocarcinoma. Of these, three signaling molecules involved in apoptotic functions ofTGF-beta have now been intensively investigated, including transmembrane receptor II (T betaRII), cell cycle inhibitor p27(Kp1) and Smad4, effectors of TGF-beta signaling pathway. Increased expression of p53 and decreased expression of maspin, a serine protease inhibitor, also play a major role in the apoptotic process. Changes in the expression of these markers may serve as a reliable criterion on making the diagnosis in biopsy material and may help choose an appropriate therapeutic approach.