良恶性前列腺组织中基质细胞表型特征改变及意义

Phenotypic differences of stroma cells in benign and malignant human prostate tissues

目的 观察良恶性前列腺组织中基质细胞的表型特征,比较其差异性.方法 应用Masson染色法和免疫组织化学技术检测前列腺癌组织中基质细胞表型特征和平滑肌肌动蛋白（SMA）、肌间线蛋白和波形蛋白表达,并与良性前列腺增生（BPH）组织相对照.按前列腺癌基质细胞阳性染色率分布,将前列腺癌基质分成4等级（0级,0％；1级,1％ ～33％；2级,34％～66％；3级,67％ ～ 100％）,比较临床局限性前列腺癌和侵袭性前列腺癌组织中基质分级特征及差异性.结果 Masson染色下可见前列腺癌基质中分布绿色染色的基质细胞,共阳性表达SMA和波形蛋白,而肌间线蛋白表达减少或阴性,为肌成纤维细胞型；BPH基质中见大量红色染色的基质细胞,阳性表达SMA和肌间线蛋白,为平滑肌细胞型；62例前列腺癌中1级13例（20％）,2级20例（32％）,3级29例（48％）,而20例BPH增生组织中1级9例（45％）,2级10例（50％）,3级1例（5％）；22例局限性前列腺癌中1级10例（45％）,2级8例（37％）,3级4例（18％）.在临床侵袭性前列腺癌中,高级别的肌成纤维细胞分布（2/3级）占83％ （33/40）,显著高于临床局限性前列腺癌（55％,12/22）,差异有统计学意义（x2 =5.573 ＞3.81,P＜0.05）.结论 良恶性前列腺组织中基质细胞分布存在差异性.前列腺癌基质分布肌成纤维细胞,并在临床侵袭性前列腺癌中高表达.

Objective To analyze the stroma changes of benign and malignant human prostate tissues.Methods For the identification of stroma cells phenotype in human prostate cancer and benign prostate hyperplasia tissues,Masson method and immunohistochemical analysis of a-smooth muscle actin （α-SMA）,desmin,and vimentin were performed.The relative volume of intratumor stroma （0%,Grade 0;1% -33%,Grade 1; 34% -66%,Grade 2; 67% -100%,Grade 3） were quantified and analyzed in local and advanced prostate cancer tissues.Results Stroma myofibroblasts in prostate cancer were stained green by Masson staining and showed a co-expression of α-SMA and vimentin without an expression of desmin.It was significantly different from smooth muscle cells in benign prostate hyperplasia stained red and co-expressing a-SMA and desmin.Statistical analysis showed that high stroma volume （Grade 2/3 ） in advanced prostate cancer were significantly higher than that in an early stage of prostate cancer （83% vs 55%,P 〈 0.05）. Conclusion Significant phenotypic differences of stroma cells existed in benign and malignant human prostate tissues.A high expression of myofibroblasts in advanced prostate cancer may play an important role in cancer progression.And its clinical significance should raise a high alert.