P504S、CK34βE12、p63、PSA在前列腺腺癌病理诊断中的应用

Expression of P504S,CK34βE12,p63 and PSA immunohistochemistry in pathological diagnosis of prostatic adenoearcinoma

目的探讨P504S(α-甲酰基-辅酶A消旋酶)、高分子细胞角蛋白(CK34βE12)、p63、前列腺特异性抗原(PSA)在前列腺腺癌病理诊断中的应用价值。方法对46例前列腺腺癌、8例前列腺高级别上皮内瘤(HGPIN)和35例良性前列腺增生(BPH)标本进行P504S、CK34βE12、PSA、p63和免疫组织化学染色。结果46例前列腺腺癌标本中,P504S阳性表达42例(91．3%),其中弥漫性胞质阳性(+++)25例(54．3%),HGPIN标本阳性7例(87．5%),1例(2．9%)BPH标本有少量腺体微弱表达；HGPIN标本中CK34βE12及p63连续或断续表达8例(100．0%),BPH标本阳性表达33例(94．3%),46例前列腺腺癌标本均未见表达；前列腺腺癌标本中PSA阳性表达44例(95．7%)。结论P504S诊断前列腺腺癌敏感性高,特异性较好,结合HE切片、CK34βE12、p63和PSA等免疫组织化学染色检测可提高前列腺腺癌病理诊断的准确性。

Objective To investigate the utility of P504S （α-methylacyl-COA racemase ）, CK34βE12,p63 and PSA immunohistochemistry in the pathological diagnosis of prostatic adenocarcinoma （PAC）, Methods The specimens of 46 cases of PAC,8 cases of prostatic high-grade intraepithelial neoplasia （HGPIN） and 35 cases of benign prostatic hyperplasia （BPH） tissues were immunohistochemically stained with PS04S,CK34βE12,p63 and PSA antibody,respectively. Results Of the 46 PAC cases, 42 （91.3%） cases showed positive for PS04S,ineluding 25 cases （54.3%） who showed strongly and diffusely positive （ ＋ ＋ ＋ ） for cytoplasmic staining. In 7 （87.5%） of the 8 HGPIN cases, the specimens were also positive for P504S, and only 1 （2.9%） of the 35 BPH cases showed focally weakly positive （ ＋ ） for P504S. All the 8 HGPIN cases （ 100% ） and 33 （94.3%） of the 35 BPH cases showed positive for CK34βE12 and p63 ,while all the 46 PAC cases showed negative for CK34βE12 and p63. In 44 （95.7%） of the 46 PAC cases,the specimens were positive staining for PSA. Conclusions P504S has high sensitivity and ,good specificity in the diagnosis of PAC. P504S staining in combination with HE, CK34βE12, p63 and PSA staining can improve the accurate diagnosis of PAC.