双染鸡尾酒抗体在前列腺腺癌和前列腺上皮内瘤中的表达及临床意义

Expression and Significance of AMACR/HMWCK/p63 Cocktail Double Staininng in Prostatic Adenocarcinoma and Prostatic Intraepithelial Neoplasia

目的探讨鸡尾酒抗体甲基酰基辅酶A消旋酶(AMACR)、高分子量角蛋白抗体(HMWCK)和p63在前列腺腺癌(Pca)、高级别前列腺上皮内瘤(HGPIN)及良性前列腺增生(BPH)组织中的表达及意义。方法收集45例Pca、40例HGPIN和45例BPH标本,按常规方法石蜡包埋,制作蜡块,进行苏木素-伊红染色及AMACR、HMWCK和p63鸡尾酒抗体双重免疫组化染色。结果 Pca中AMACR阳性率为84.4%;HGPIN中AMACR阳性率为82.5%,与Pca中比较差异无统计学意义(P>0.05);BPH中AMACR阳性率为24.4%,与Pca和HGPIN比较差异均有统计学意义(P<0.05)。HMWCK和p63在高分化Pca中均呈阴性,15.6%中分化和低分化Pca的癌巢周围可见,HGPIN和BPH中均呈阳性表达,但其分布方式不同,在HGPIN中呈连续或间断性分布,从HGPIN至癌移行腺体中逐渐减少至消失,在BPH中呈连续性分布。HMWCK和p63在Pca的表达与HGPIN和BPH比较,差异有统计学意义(P<0.05)。结论鸡尾酒抗体AMACR、HMWCK和p63对诊断高分化Pca有较高的特异性和敏感性,同时对高分化Pca和异型病变的鉴别诊断有价值。

Objective To investigate the expression and significance of a triple cocktail antibodies,AMACR,HMWCK and p63,in human prostatic adenocarcinoma（Pca）,high grade prostatic intraepithelial neoplasia（HGPIN）and benign prostatic hyperplasia（BPH）. Methods Forty-five Pca,40 HGPIN and 45 BPH specimens were collected.Conventional paraffin-embedding and serial section tissues were used to perform HE and immunohistochemical cocktail staining（AMACR/HMWCK/p63）.The expression of AMACR/HMWCK/p63 cocktail antibodies was detected by immuohistochemisitry staining（cocktail antibody double staining）.The expression of the AMACR/HMWCK/p63 and the relationship with histopathologic classification were analyzed. Results The positive rate of AMACR in Pca was 84.4%,and the positive rate of AMACR in HGPIN was 82.5%,the difference was not statistical（P0.05）.While the positive rate of AMACR in BPH was 24.4%,showing significant difference compared with those in Pca and HGPIN（P0.05）.The percentage of AMACR staining intensity in PCas（84.4%） were significantly higher than in HGPINs（82.5%）and BPHs（24.4%）（P0.01）.The expression of HMWCK/p63 was significantly higher in BPHs and HGPINs than PCas（P0.01）.There was no statistically significant difference of HMWCK/p63 staining between BPH and HGPIN,and its expression was unrelated to Gleason grading of PCa（P0.05）.The expression of HMWCK and p63 showed statistical difference between Pca,HGPIN and BPH（P0.05）. Conclusion AMACR/HMWCK/p63 expression is different in Pca,HGPIN and BPH.AMACR/HMWCK/p63 cocktail staining is useful for the diagnosis of well differentiated adenocarcinoma,benign and malignant prostate disease.