p504s、ck5/6和p63表达水平在前列腺增生和前列腺癌中的诊断价值

Diagnostic value of p504s, ck5/6 and p63 expression level in benign prostatic hyperplasia and prostate cancer

目的研究α甲酰基辅酶A消旋酶(p504s)、细胞角蛋白5/6(ck5/6)和p63在前列腺增生和前列腺癌中的诊断价值。方法采用免疫组织化学染色法检测江苏省无锡市惠山区人民医院及江苏省无锡市锡山人民医院病理科2012年1月~2017年12月收集的120例前列腺穿刺活检样本中p504s、ck5/6和p63的表达情况,其中前列腺癌70例(前列腺癌组)、前列腺增生50例(前列腺增生组)。将65例前列腺腺泡细胞癌按照Gleason分级标准分为≤6分组(20例)、7~8分组(26例)和≥9分组(19例)三个亚组。根据染色强度、阳性细胞百分数的乘积结果作为结果来进行比较。采用SPSS 15.0统计软件对结果进行统计学分析。结果前列腺癌组中p504s表达率为91.43%,其中64.28%(45/70)为强阳性。前列腺增生组仅5例为p504s弱阳性表达,表达率为10.00%。ck5/6在前列腺癌组中表达阳性率为11.43%(8/70),且均为弱阳性;前列腺增生组90.00%(45/50)为ck5/6阳性表达,且84.00%(42/50)为中等强度以上阳性表达。p63在前列腺癌组中表达阳性率为8.57%(6/70),且均为弱阳性;前列腺增生组中92.00%(46/50)为p63阳性表达,且82.00%(41/50)为中等强度以上阳性表达。两组p504s、ck5/6和p63表达情况比较,差异有统计学意义(P<0.05)。Gleason分级≤6分组、7~8分组和≥9分组p504s表达强度差异有统计学意义(P<0.05),其中7~8分组和≥9分组p504s表达强度显著高于≤6分组(P<0.05),但7~8分组和≥9分组的p504s表达强度差异无统计学意义(P>0.05)。腺体部分性萎缩、腺体完全性萎缩和基底细胞增生三种类型的前列腺增生组织中ck5/6、p63表达强度差异均无统计学意义(P>0.05)。腺体部分性萎缩和腺体完全性萎缩中各有3例和2例ck5/6表达缺失,均有2例p63表达缺失。结论 p504s在前列腺癌组织中明显高表达,而p63、ck5/6表达明显降低,且p504s表达强度随着Gleason分级的增高而增强,提示三者联合检测在前列腺癌和良性病变的诊断中有良好的应用价值。

Objective To study the diagnostic value of alpha methylacyl coenzyme A racemase（p504 s）, cytokeratin5/6（ck5/6） and p63 in benign prostatic hyperplasia（BPH） and prostate cancer. Methods Immunohistochemical staining method was used to detect the expression of p504 s, ck5/6 and p63 in 120 cases of prostate biopsy specimens that collected in Department of Pathology, Huishan People＇s Hospital of Wuxi City and Xishan People′s Hospital of Wuxi City from January 2012 to December 2017. In the 120 cases, 70 cases were prostate cancer（prostate cancer group）, 50 cases were BPH（BPH group）. 65 cases of patients with prostate acinic cell carcinoma were divided into three subgroups according to the Gleason classification standard： ≤6 scores group（20 cases）, 7-8 scores group（26 cases） and ≥9 scores group（19 cases）. The product of staining intensity and percentage of positive cells was compared among these groups.Statistical software SPSS 15.0 was used to analyze the results. Results The expression rate of p504 s in the prostate cancer group was 91.43%, 64.28%（45/70） were strongly positive. Only 5 cases of BPH group were p504 s weakly positive, and the expression rate was 10.00%. The positive rate of ck5/6 expression in prostate cancer group was 11.43%（8/70）, and all of them were weakly positive. 90.00%（45/50） of BPH group were ck5/6 positive expression, and 84.00%（42/50） were positive expression above medium intensity.The positive rate of p 63 expression in prostate cancer group was 8.57%（6/70）, and all of them were weakly positive. 92.00%（46/50） of BPH group were p63 positive, and 82.00%（41/50） were positive expression above medium intensity. There was a significant difference in the expression of p504 s, ck5/6 and p63 in the two groups（P〈0.05）.There was a significant difference in the expression intensity of p504 s in ≤6 score group, 7-8 score group and ≥9 score group（P〈0.05）. The expression intensity of p504 s in 7-8 score group and ≥9 score group were significantly higher than that in ≤6 score group（P〈0.05）. The expression intensity of p504 s in 7-8 score group and ≥9 score group had no significant difference（P〉0.05）. There was no significant difference in the expression intensity of ck5/6 and p63 among three types of benign prostatic hyperplasia tissues, which included partial atrophy of glands, complete atrophy of glands, and hyperplasia of basal cells（P〉0.05）. There were 3 cases of ck5/6 deletion, and 2 cases of p63 expression deletion in the glandular partial atrophy. There were 2 cases of ck5/6 expression deletion, and 2 cases of p63 expression deletion in the complete atrophy of glands. Conclusion The expression of p504 s is highly expressed in the prostate cancer tissue, while the expression of p63 and ck5/6 is decreased significantly. The expression intensity of p504 s is enhanced with the degree increase of Gleason classification. It is suggested that the combined detection of p504 s, ck5/6 and p63 has good application value in the diagnosis of prostate cancer and BPH.