混合型p504s/34βE12/p63抗体在前列腺腺癌诊断中的应用价值

Value of p504s/34βE12/p63 Cocktail in diagnosis of prostate adenocarcinoma

目的评价混合型p504s/34βE12/p63抗体和双重染色技术在诊断前列腺腺癌中的价值。方法选择47例前列腺病例,包括36例前列腺癌、4例不典型腺瘤样增生、4例良性增生和3例间质肉芽肿性炎。采用混合型p504s/34βE12/p63抗体和双酶标记法检测这3种抗原在各类病变中的表达状况。p504s阳性表现为胞质内蓝黑色颗粒状物,而基底细胞的核(p63)和胞质(34βE12)呈红色着色。结果在36例前列腺癌中,32例(88·89%)表达p504s,其中5例为小灶性癌,所有癌细胞巢周围无肌上皮细胞(34βE12和p63阴性)。在4例不典型腺瘤样增生中,1例p504s阳性,但腺上皮细胞周围也有肌上皮细胞(34βE12和p63阳性)。其余7例良性病变中p504s阴性。无非癌性病变同时出现p504s阳性而34βE12和p63阴性的情况。单标抗体p504s和混合型p504s在前列腺病变中的表达一致率为91·49%。结论混合型p504s/34βE12/p63抗体双标在前列腺癌的诊断中具有很高的敏感性和特异性,与单标抗体比较,更容易观察、分辨,有助于提高小灶性前列腺癌的检出率。该法适用于常规病理诊断中,尤其是穿刺活检的小标本,而且减少了免疫组化染色片的数量。

Purpose To assess the value of p504s/34β12/p63 cocktail and a double-chromogen reaction for the diagnosis of prostate adenoeareinima. Methods 47 cases of different prostate lesions were chosen in Department of Pathology, Beijing Friendship Hospital, including 36 prostate carcinomas, 4 atypical adenomatous hyperplasia, 4 benign prostatic hyperplasia and 3 nonspecific granulomatous prostatitis. 3-antibedy cocktail and 2 chromogen reactions were used to detect the expression of p504s/34β12/p63 in different prostate lesions, p504s expressed in malignant glandular epithelium with a blue-black cytoplasmic granular staining pattern. However, basal cells showed red nuclear （p63） and cytoplasmic （34βE12） staining. Results Of 36 prostatic cancer cases, 32 （88. 89 % ） expressed p504s, including 5 cases of prostatic micro-adenoearcinoma. All malignant glands were negative for basal cell staining. 1 case of AAH expressed p504s, but there were red basal cells around blue-black glandular epithelium of AAH. No nonmalignant glands were found simultaneously negative for basal cell markers and positive for p504s. Concordant rate for the expression of p504s was 91.49% between single antibody and triple-antibody cocktail staining. Conclusions Immunohistoehemical analysis with a triple-antibody cocktail （ p504s/34βE12/p63 ） and double color is an assay with high sensitivity and specificity for prostate carcinoma. Compared with single antibody staining, p504s positivity is more easily separable from basal cell staining with the double-color reactions. Immunohistoehemistry with a triple-antibody cocktail and double color improves the detection rate of small focal prostate carcinoma. It can be used as a routine assay in clinical practice and will reduce the number of stained slides required in limited biopsy materials.