α-甲基-辅酶A消旋酶在前列腺癌中的表达及意义

Expression and diagnostic utility of P504S in prostate cancer

目的 探讨α 甲基 辅酶A消旋酶 (P5 0 4S)表达在国人前列腺癌病理诊断中的价值。 方法 对 4 2例前列腺癌、18例前列腺上皮内瘤 (PIN)和 2 5例良性前列腺增生 (BPH)标本进行P5 0 4S、高分子质量角蛋白 (34βE12 )和血管内皮生长因子 (VEGF)免疫组化染色 ,观察比较分析染色范围和强度。 结果 前列腺癌标本P5 0 4S染色阳性 33例 (79% ) ,染色强度为中等到强阳 ,明显高于BPH和PIN ,癌旁组织均为阴性 ;6例 (33% )PIN标本 ,2例 (8% )BPH标本有少量细胞微弱表达 ,其余均为阴性。BPH标本具有完整基底层细胞 ,34βE12 呈阳性表达 ;PIN腺体基底层细胞 34βE12 表达阳性 ,相对BPH强度减弱 ;4 0例前列腺癌腺体无基底层细胞 ,仅 2例有不完整的基底层呈弱表达。BPH、PIN和前列腺癌标本VEGF均呈阳性表达 ,各组阳性细胞数和染色强度相差不明显。 结论 P5 0 4S诊断前列腺癌敏感性高、特异性好 ,结合 34βE12 检测可提高前列腺癌的检出率。

Objective To investigate the expression and pathological diagnostic utility of α-methylacyl-coenzyme A racemase(P504S)in prostate cancer(PC). Methods The specimens of 42 cases of PC,18 cases of prostatic intraepithelial neoplasia(PIN)and 25 cases of benign prostatic hyperplasia(BPH)tissues were immunohistochemical stained with P504S,34βE 12 and vascular endothelial growth factor(VEGF)antibody,respectively. Their staining extent and intensity were analyzed and compared. Results Of the 42 PC cases,33(79%)showed positive P504S staining with moderate to strong staining intensity, which was significantly stronger than that of PIN and BPH cases,while adjacent normal glands were all negative. Weakly positive P504S staining was found in 6(33%)of 18 PIN cases and 2(8%)of 25 BPH cases,while it was negative in others.The specimens of BPH cases had a complete basal cell layer and were positive for 34βE 12 ;while 40 cases of PC had no basal cell layer and only 2 cases had discontinuous basal cell layers with weak staining.The basal cell layers of PIN cases were positive for 34βE 12 and the staining was a little weaker than that of BPH cases.All the specimens of BPH,PIN and PC cases showed positive staining for VEGF,the extent and staining intensity had no significant difference among these groups. Conclusions P504S has high sensitivity and good specificity in the diagnosis of PC,and is helpful for differentiating the suspected cases when combined with 34βE 12.