前列腺特异抗原和高分子量细胞角蛋白改良免疫组织化学染色法对前列腺癌的诊断作用

Differential diagnosis of prostatic cancer by modified immunohistochemistry of prostatic specific antigen and high molecular weight cytokeratin

目的 探讨前列腺特异抗原 (PSA)和高分子量细胞角蛋白 (CK3 4βE12 )改良免疫组织化学染色法对前列腺癌鉴别诊断的作用。方法 对 5 2例疑难病例采用改良免疫组织化学染色法检查。即在同一切片的一侧贴附可靠的阳性对照组织 ,应用微波处理 ,尽可能保存和修复抗原 ,在显微镜下严格控制显色等方法以达到最佳染色效果。结果 3例前列腺不典型腺瘤样增生(AAH)、3 7例前列腺上皮内瘤 (PIN)高表达PSA与CK3 4βE12 ;3例前列腺导管内癌也表达PSA及CK3 4βE12 ;9例前列腺腺癌仅表达PSA无CK 3 4βE12表达 ;10例膀胱移行上皮癌均不表达PSA与CK3 4βE12。 结论 PSA和CK3 4βE12的改良免疫染色可以作为前列腺癌鉴别诊断的工具之一 ,对指导临床治疗可发挥重要作用。

Objective To explore the differential diagnostic value of prostatic specific antigen (PSA) and high molecular weight cytokeratin (CK34βE12) to prostatic cancer (PC).Methods An immunohistochemical method for PSA and CK34βE12 was modified as follows:(1) A reliably positive control tissue section was adhered beside the tested tissue section on the same slide;(2) The slide was treated with microwave oven to preserve and repair the antigens and (3) Developing the colour of sections must be controlled microscopically until the background was clear.Results PSA and CK34βE12 were highly expressed in 3 cases of atypical adenomatiod hyperplasia (AAH)and in 37 cases of prostatic intraepithelial neoplasia (PIN),and normally expressed in 3 cases of prostatic ductal adenocarcinoma.PSA but not CK34βE12 was expressed in 9 cases of prostatic adenocarcinoma.Neither PSA nor CK34βE12 was expressed in the 10 cases of transitional cell carcinoma.By this method precursor lesions of prostatic cancer and prostatic cancers as well as other prostatic diseases could be differentiated clearly.Conclusion Modified immunohistochemistry of PSA and CK34βE12 can be applied as one of differential diagnostic methods for prostatic cancer.