AMACR(P504S)、P63、34βE12联合检测在前列腺癌早期诊断中的应用

Detection of AMACR (P504S), P63 and 34βE12 Cocktail in the Early Diagnosis of Prostate Cancer

目的:探讨AMACR(P504S)、P63、34βE12联合检测在前列腺癌(PCa)早期诊断中的临床应用价值。方法:应用即用型组合式单克隆抗体和双酶标记的免疫组化MaxvisionTM一步法检测42例PCa、12例高级别前列腺上皮内瘤变(HGPIN)和30例良性前列腺增生(BPH)穿刺活检标本中AMACR、P63、34βE12的表达情况。比较Glea-son评分各组中AMACR阳性表达情况。结果:AMACR、P63、34βE12抗原在PCa和BPH穿刺标本中的表达差异均有极显著性(P<0.01),PCa组织中AMACR阳性表达率为100%,无P63和34βE12表达;BPH组织中均无AM-ACR表达,P63和34βE12均高表达。HGPIN中AMACR的阳性表达率(91.67%)与BPH差异有极显著性(P<0.01),与PCa差异无显著性(P>0.05);P63和34βE12阳性表达率HGPIN(100%)与PCa差异有极显著性(P<0.01),而与BPH差异无显著性(P>0.05)。AMACR表达强弱与PCa的Gleason评分无关(P>0.05)。结论:AMACR是PCa高度敏感和特异的标志物,P63和34βE12联合标记基底细胞的特异性高,3者联合检测能增加前列腺穿刺活检标本诊断的准确性,在PCa早期诊断中具有重要的临床应用价值。

Objective： To investigate the value of detection of AMACR （P504S）, P63 and 34βE12 cocktail in the early diagnosis of prostate cancer （PCa）. Methods： The expressions of AMACR, P63 and 34βE12 were examined in the biopsy specimens of 42 cases of prostate cancer, 12 cases of high-grade prostatic intraepithelial neoplasia （ HGPIN ） and 30 cases of benign prostatic hyperplasia （BPH） using the maxvisionTM single-step immunohistochemical method with triple-antibody cocktail （AMACR/P63/34βE12） staining and double-color chromogens in single paraffin sections . Results： The expressions of AMACR, P63 and 34βE12 were significantly different between PCa and BPH （P 〈0.01 ）. The staining of PCa was positive for AMACR and negative for P63 and 34βE12, and the positivity rate of AMACR was 100%. BPH was strongly expressed for P63 and 34βE12, but negatively for AMACR. The expression of AMACR was significantly different between HGPIN and BPH （P 〈0.01 ） , but not between HGPIN and PCa （P 〉0.05 ） , and the positivity rate of AMACR in HGPIN was 91.67%. However, the expressions of P63 and 34βE12 were significantly different between HGPIN and PCa （P 〈0.01 ）, but not between HGPIN and BPH （P 〉0.05）, and the positivity rate of AMACR in HGPIN was 100%. The level of AMACR expression was not correlated with PCa Gleason score （ P 〉 0.05 ）. Conclusion ： AMACR is a sensitive and specific marker for PCa. P63 and 34βE12 cocktail staining can increase the sensitivity and specificity of the basal cell detection. The immunohistochemical analysis with triple-antibody cocktail （AMACR/P63/34βE12） staining and double-color chromogens can improve diagnostic accuracy and has an important applied value for the early diagnosis of prostate cancer.