成对氨基酸转化酶-4在前列腺癌组织中的表达及临床意义

Paired basic amino acid cleaving enzyme 4 expression in prostate cancers and its clinicopathologic significance

目的探讨成对氨基酸转化酶-4（PACE4）在前列腺癌组织中的表达及临床意义。方法应用免疫组织化学方法检测PACE4在72例前列腺癌（PCa）、10例前列腺上皮内瘤变（PIN）和40例良性前列腺增生症（BPH）组织中的表达。结果PACE4在PCa、PIN及BPH中的阳性率分别为92％、80％及20％，差异有统计学意义（P〈0．05）；以PACE4阳性区分PCa与非PCa的正确率达82％，Youden指数为60％（95％可信区间为45％-74％）。PACFA阳性表达程度与前列腺癌临床分期、血清前列腺特异抗原（PSA）水平、肿瘤分级（Gleason评分）呈线性正相关，不同危险组之间的PACE4阳性表达率差异有统计学意义（P〈0．05）。结论PACE4可良好区分PCa、PIN和BPH，有效诊断PCa，且能较好地反映前列腺癌危险等级。

Objective To investigate the expression of paired basic amino acid cleaving enzyme 4 （PACE4） in prostate cancers and its clinical significance. Methods Expression of PACFA was examined by immunohistochemistry in 72 cases of prostate cancer （PCa） , 20 cases of prostatic intraepithelial neoplasia（PIN） and 40 cases of benign prostatic hyperplasia （BPH）. Results The positive rates of PACE4 in PCa, PIN and BPH were 92% , 80% and 20% respectively, with a significant difference among them （P 〈 0. 05）. Its accuracy rate and Youden index（95% confidence interval） were 82% and 60% （45%-74% ） respectively when diagnosing PCa and Non-PCa. A positive linear trend was found between PACE4 expression and clinical stage, preoperative serum prostate specific antigen （PSA） level, Gleason score and estimated-risk. Conclusion PACFA expression in prostate tissue could well differentiate PCa from PIN ＆ BPH, and could represent the prognostic risk appropriately.