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Intraepithelial lymphocytes in relation to NIH category IV prostatitis in autopsy prostate
Dorian Dikov1, Svitlana Bachurska2, Dimitri Staikov2
1Groupement Hospitalier De L'est Francilien, Hôpital de Jossigny, Service d'Anatomie et Histologie Pathologiques, Jossigny, France.
Insights
The number of intraepithelial lymphocytes (IELs) in prostate tissue can indicate inflammation. More than 1 IEL per 100 epithelial cells suggests category IV prostatitis, with higher counts correlating to inflammation severity.
Area of Science:
- Urology
- Immunology
- Pathology
Background:
- Quantitative analysis of lymphocytes and epithelial cells (ECs) in the prostate is crucial for understanding prostatic diseases.
- Intraepithelial lymphocytes (IELs) play a role in normal prostatic epithelium, benign prostatic hyperplasia (BPH), and high-grade prostatic intraepithelial neoplasia (PIN).
- The significance of IELs in relation to NIH category IV prostatitis (histologic prostatitis: HP) was investigated in autopsy prostate samples.
Purpose of the Study:
- To quantitatively analyze the number and ratio of IELs in normal prostate tissue and in relation to category IV prostatitis.
- To establish normal basal levels of prostatic IELs and identify thresholds indicative of HP.
- To explore the correlation between IEL counts and the severity and localization of HP, BPH, and PIN.
Main Methods:
- Analysis of IELs in 59 autopsy prostates using immunohistochemistry for CD3.
- Counting an average of 300-500 epithelial cells (ECs) per case to calculate IELs as mean/100 ECs.
- Evaluation of category IV prostatitis using the NIH consensus grading system for anatomical localization and grade.
Main Results:
- Normal prostates had a mean of 0.61 ± 0.34 IELs/100 ECs (≤1 IEL/100 ECs).
- Category IV prostatitis cases showed a mean of 8.53 ± 3.25 IELs/100 ECs (5-11 IELs/100 ECs).
- IEL numbers correlated significantly with HP grade and location, acute glandular inflammation, stromal lymphocytes, and BPH/PIN-associated inflammation.
Conclusions:
- The normal upper limit for CD3+ IELs in the prostate is 1 lymphocyte/100 ECs, representing prostate-associated lymphoid tissue (PALT).
- Values exceeding 5 IELs/100 ECs indicate category IV prostatitis, with severity correlating to IEL count.
- Increased IELs suggest an immune or autoimmune component in category IV prostatitis, BPH, and inflammatory PIN lesions within the prostatic tumor microenvironment.
Background:
Quantitative analysis of the number, normal and pathologic ratios between lymphocytes and epithelial cells (ECs), and the significance of intraepithelial lymphocytes (IELs) in normal prostatic epithelium, benign prostatic hyperplasia (BPH), and high grade prostatic intraepithelial neoplasia (PIN) in relation to NIH category IV prostatitis (histologic prostatitis: HP) was studied in autopsy prostate.
Methods:
IELs were analysed in 59 autopsy prostates, which was routinely embedded in paraffin and immunohistochemically stained for CD3. An average of 300-500 ECs were counted per case. The number of IELs was calculated as the mean/100 ECs. Category IV prostatitis was evaluated using NIH consensus grading system in terms of anatomical localization and grade.
Results:
In healthy individuals the mean number of IELs/100 ECs was 0.61 ± 0.34% or ≤1 lymphocyte/100 ECs, which is considered as the normal basal level of prostate IELs. In category IV prostatitis, the mean number of IELs/100 ECs was 8.53 ± 3.25% or 5-11 lymphocytes/100 ECs. The number of IELs in both around and inside inflammation areas correlated to the grade and location of HP (P < 0.0001 and P < 0.0003), the presence of acute glandular inflammation (P < 0.0001), the scattered stromal lymphocytes (P = 0.029), and BPH and PIN associated prostatic inflammation (P < 0.0001).
Conclusion:
The study presents the first attempt to examine and score the basic quantitative values of prostatic IELs in normal prostate and in relation to category IV prostatitis. The detected normal upper limit of CD3+ IELs is 1 lymphocyte/100 ECs in the normal prostate epithelium. This is considered as an organ specific characteristic of the prostate-associated lymphoid tissue (PALT). Values >5 IELs/100 ECs indicate the presence of category IV prostatitis. The severity of inflammation correlates to the number of IELs. There is an intimate link between the quantity of the IELs, the degree of the severity and the localization of category IV prostatitis. HP is a chronic and dynamic inflammatory process affecting the whole prostate gland. The increased number of IELs suggests the immune or autoimmune character of category IV prostatitis, BPH and inflammatory preneoplastic (PIN) lesions in the prostatic tumor environment.
