Effect of neoadjuvant endocrine therapy on the acoustic environment in tissue of prostate cancer: a study of histopathological characteristics.

Background: Neoadjuvant endocrine therapy (NET) of prostate cancer (PCa) may alter the tissue acoustic environment (AET). The structure of tissue is an important factor affecting AET. The aim is to analyze changes in tissue structures after NET in PCa, focusing on calcifications, smooth muscle cells, and blood vessels.

Methods: We collected 40 patients diagnosed with PCa by pathological examination between October 2020 and December 2022. Twenty patients who underwent radical prostatectomy (RP) after NET were designed as the test group. Twenty patients without NET were assigned to the control group. Calcifications, smooth muscle cells and blood vessels were observed by hematoxylin-eosin (HE) staining and Van Gieson (VG)-special staining respectively. Then the amount and acreage of calcified tissue, the number of smooth muscle cells and different types of blood vessels were quantitatively analyzed.

Results: There was a subtle increase in the number (P=0.001) and the area (P<0.001) of calcification after NET. The total number of smooth muscle cells was significantly higher than that without NET (P<0.001). NET resulted in significantly fewer veins compared to those without NET (P<0.001). There was a little increase in the number of arteries after NET (P=0.001). The number of veins decreased was much greater than the number of arteries increased resulting in significantly fewer total vessels after NET (P<0.001).

Conclusions: NET can lead to changes in calcifications, smooth muscle cells, and blood vessels within PCa tissues, which may cause alterations in AET.