高分子质量细胞角蛋白结合前列腺特异性抗原及P53标记物在前列腺癌鉴别诊断中的临床意义

Clinical Value of CK34BE12 Combining the Expression of Protein P53 Gene and Prostate Specific Antigen for the Differential Diagnosis of Prostate Carcinoma

目的:提高对前列腺良、恶性病变的临床认识和鉴别诊断水平。方法:用免疫组化染色法分别对前列腺腺癌13例、前列腺上皮内瘤和不典型腺瘤样增生22例、良性前列腺增生74例患者病变组织作抗高分子质量细胞角蛋白抗体(CK34BE12)、前列腺特异性抗原(PSA)及突变型P53的表达。结果:9例前列腺癌的腺体基底细胞区CK34BE12染色为阴性;4例染色大部分区域呈现阴性,染色区域部分腺体CK34BE12的染色呈现断续的阳性反应,PSA表达阴性,P53表达呈阳性,阳性细胞标记指数>15%。13例前列腺上皮内瘤和不典型腺瘤样增生腺体基底细胞区CK34BE12染色呈阳性,9例基底细胞区CK34BE12染色呈现断续阳性的区域占主体,染色小部分区域呈现阴性,染色区域PSA表达减弱,P53表达呈阳性,阳性细胞标记指数<15%。74例良性前列腺增生的腺体基底细胞对CK34BE12染色均呈强阳性,染色的反应带呈现不规则粗线形连续环状强阳性着色围绕在腺周,染色区域中PSA表达呈现阳性,P53表达呈阴性。结论:在组织形态学观察的基础上联合应用CK34BE12及PSA标记物可特异地显示前列腺腺体基底细胞的存在及间接了解其基底细胞层的完整性与否,结合P53的表达判断致癌基因的存在;对前列腺良、恶性病变的鉴别诊断及肿瘤恶性程度的准确判断具有很大帮助,且对前列腺癌的早期诊断也有很好的应用价值。

Objective ： To improve the level of clinical diagnosis and differential diagnosis of benign and malignant prostate lesions. Methods： One hundred and nine cases of prostate cancer and prostate hyperplasia were evaluated by the expression of high molecular weight cytokeratin （CK34BE12） , prostate specific antigen （PSA） and protein P53 gene using the immunohistochemical technique. Results： The basal-cells in all of the benign lesions were stained with the CK34BE12 and PSA, while it had not immunoreactivity with P53. In contrast, the prostate carcinoma were not stained or partly stained with the CK34BE12 and PSA, but P53 show significant immunoreactivity with the tissue. Conclusion： Based on the routine histological studies with the expression of CK34BE12 and PSA together, they can indicate the existence of basal-cell distinctly and show indirectly whether the basal-cell is integrated. Combining the expression of P53 to determine the existence of cancer gene, it can help to distinguish benign and malignant prostate lesions.