前列腺组织中AMACR表达的临床意义

Expression of α-methylacyl CoA racemase in prostate cancer and its clinical significance

目的:检测α-甲基酰基辅酶A消旋酶(-αmethylacyl-CoA racemase,AMACR)在前列腺组织中的表达,探索前列腺癌诊断的新方法。方法:前列腺针刺标本108例,用AMACR抗体作免疫组化染色。同时,随机抽取其中的24例病例,每个病例抽取1个针刺标本,用Western blot方法检测AMACR在前列腺癌中的表达,与病理诊断相比较。结果:用免疫组化染色的方法检测AMACR在前列腺癌中的表达,与病理诊断结果相比较,在61例良性标本中,阴性59例,假阳性2例,符合率为96.7%。在44例腺癌中,阳性41例,漏诊3例,符合率为93.2%,总符合率为92.6%。前列腺小细胞癌1例,表达阳性,转移癌1例,表达阴性,高级别前列腺上皮内瘤(high grade prostatic intraepithelial neoplasia,HPIN)1例,表达为弱阳性。用West-ern blot方法检测,与病理诊断结果相比较,符合率为87.5%。在14例良性标本中,阴性14例,假阳性为0,符合率100%。10例癌症标本中,阳性7例,漏诊3例,符合率70%。用免疫组化法检测AMACR在前列腺癌中的表达,可以显示微小癌灶。结论:AMACR是前列腺癌诊断有用的新指标,具有广阔的应用前景。用AMACR结合Western blot,对于前列腺癌的诊断,有一定的临床意义,值得进一步研究。

Objective： To detect the expression of alpha-methylacyl CoA racemase （AMACR） in prostate tissue and to establish a new method for diagnosis of prostate cancer. Methods.. Irnmunohistochemical staining was performed on 108 prostate needle biopsies with AMACR antibodies. Among these cases, western blot analysis was performed on 24 biopsies randomly taken from 24 patients. All the tesls were performed using double-blind method. The results of immunohistochemical staining and western blot were compared with the pathological records. Results：Compared immunohistochemical results with pathological records, 59 out of 65 benign prostatic specimens were AMACR negative and 2 specimens were false-positive. The coincidence rate was 96.7%. In 44 cases of adenocarcinomas, 41 cases were AMACR positive and 3 cases were missed in diagnosis. The coincidence rate of two methods was 93.2% and the total coincidence rate was 92.6%. There was 1 case of prostate small cell carcinoma with AM ACR-positive staining, 1 case of metastatic prostate cancer with AMACR-negative staining, and 1 case of high grade prostatic intraepithelial neoplasia （HPIN） with AMACR-weak positive staining. Compared western blot results with the pathological records, the coincidence rate of lhe two methods was 87.5 %, Fourteen out of 14 benign prostatic specimens were AMACR negative and no specimen was false positive. The coincidence rate was 100%. Seven out of 10 prostate cancer specimens were AMACR-positive and 3 were missed in diagnosis. The coincidence rate was 70%. The results of western blot showed clear bands and definite patterns between positive and neg ative cases. Micro loci of prostate cancers could be found by detecting AMACR expression using immunohistochemical method. Conclusion：AMACR is a new biomarker for prostate cancer diagnosis. Irnmunohistochemical staining for AMACR combined with western blot analysis had clinical significance in the diagnosis of prostate cancer and worthy of further research.