P504S,34βE12,P63及前列腺特异性抗原在前列腺癌中的表达特点及诊断意义

Expressive characteristics of P504S,34βE12,P63,and prostate-specific antigen in prostatic carcinoma and the significance for diagnosis

目的:观察α-甲基-辅酶A-消旋酶(alpha-methylacyl-CoA racemase,P504S)、角蛋白-903(34βE12)、P63及前列腺特异性抗原(prostate-specific antigen,PSA)在不同性质前列腺穿刺标本中的表达特点,探讨它们在前列腺癌病理诊断及鉴别诊断中的意义。方法:收集中南大学湘雅二医院前列腺穿刺活检标本238例,其中前列腺癌140例,前列腺转移性癌10例,良性前列腺增生72例,前列腺高级别上皮内瘤16例。采用免疫组织化学方法检测P504S,34βE12,P63及PSA在前列腺病变中的表达情况。结果:P504S在前列腺癌中呈高表达(阳性率91.43%),在其他3种组织中均表达很低(P<0.05);34βE12与P63在前列腺癌中阳性率(1.42%)均低于高级别前列腺上皮内瘤及前列腺增生(分别为93.75%和97.22%,P<0.05);PSA除在前列腺转移癌中呈阴性表达外,在其他3种组织均为阳性。结论:联合检测P504S,34βE12,P63及PSA,并结合病理形态综合分析,才能有助于前列腺癌的确诊。

Objective To observe the expression of alpha-methylacyl-CoA racemase（P504S）,cytokeratin-903（34βE12）,P63,and prostate-specific antigen（PSA） in prostate needle biopsy specimens and to explore the significance in diagnosis and differential diagnosis for prostatic carcinoma.Methods The expression of P504S,34βE12,P63,and PSA was detected by immunohistochemistry in 238 cases of prostate needle biopsy tissues embedded in paraffin,which includes the samples from prostatic carcinoma（n=140）,prostate metastatic carcinoma（n=10）,benign prostatic hyperplasia（BPH,n=72）,and high grade prostatic intraepithelial neoplasia（HGPIN,n=16）.Results The expression of P504S was significantly higher in prostatic carcinoma than that in prostate metastatic carcinoma,HGPIN,and BPH（91.43% vs.20%,25%,or 9.72%,P0.05）.The positive rate for both 34βE12 and P63 were 1.42% in prostatic carcinoma,which was lower than that of HGPIN and BPH（P0.05）.The expression of PSA was negative in prostate metastatic carcinoma while positive in prostatic carcinoma,HGPIN,and BPH.Conclusion Combined detection of P504S,34βE12,P63,and PSA plus meta-analysis are contributed to improve pathological diagnosis accuracy of prostatic carcinoma.