Prediction value of high-grade prostatic intraepithelial neoplasia for prostate cancer on repeat biopsies

Objective: The significance of isolated high-grade prostatic intraepithelial neoplasia in initial biopsy as an predic-tor for prostate cancer has been extensively research, and the true relationship remnant is no clear till now. The aim of this study is to evaluate prediction value of cancer on repeat biopsy in patients with high-grade prostatic intraepithelial neoplasia, using multivariate analysis. Methods: Thirty-eight men with a diagnosis of isolated high-grade prostatic intraepithelial neo-plasia in initial needle biopsy were studies, in the Fist Affiliated Hospital of Medical School of Xi'an Jiaotong University, from January 2003 to March 2009. These samples were using immunostaining of p63 and 34βE12 and P504s, with a median fol-low-up of 525 (range, 7 to 1650) days, and to researched the incidence of subsequent prostate cancer, and to predicted the risk of prostate cancer in clinicopathological parameters of isolated high-grade prostatic intraepithelial neoplasia on repeat biopsies by logistic regression analysis. Results: There were 10 of 38 (26.3%) men with prostate cancer on repeat biopsies after diagnosis isolated high-grade prostatic intraepithelial neoplasia in initial biopsy, of the rates of prostate cancer were 80% for micropapillary and 75% for cribriform high-grade prostatic intraepithelial neoplasia (P < 0.05), respectively. The positive cores of isolated high-grade prostatic intraepithelial neoplasia was the important for the risk of prostate cancer using Multi-factor logistic regression analysis. The time range in 30 to 690 days was stronger risk for prostate cancer detection after diagnosis isolated HGPIN in initial biopsy. p63 and 34βE12 were disrupted positive expression, and P504S was weak posi-tive expression in the 61% isolated high-grade prostatic intraepithelial neoplasia. Conclusion: Isolated high-grade prostatic intraepithelial neoplasia on repeat biopsy conferred a 26.3% risk of prostate cancer, and this risk level is lower than the previ-ously reported risk of 24% to 58%. The number of positive cores and the histopathological pattern with high-grade prostatic intraepithelial neoplasia on initial biopsy was significantly associated with the risk of cancer.

Characteristics and risk factor analyses of high-grade intraepithelial neoplasia in older patients with colorectal polyps

BACKGROUND According to the degree of intradermal neoplasia in the colorectal exhalation,it can be divided into two grades:Low-grade intraepithelial neoplasia(LGIN)and high-grade intraepithelial neoplasia(HGIN).Currently,it is difficult to accurately diagnose LGIN and HGIN through imaging,and clinical diagnosis depends on postoperative histopathological diagnosis.A more accurate method for evaluating HGIN preoperatively is urgently needed in the surgical treatment and nursing intervention of colorectal polyps.AIM To explore the characteristics and risk factors of HGIN in older patients with colorectal polyps.METHODS We selected 84 older patients diagnosed with HGIN as the HGIN group(n=95 colonic polyps)and 112 older patients diagnosed with LGIN as the LGIN group(n=132 colonic polyps)from Shandong Provincial Hospital Affiliated to Shandong First Medical University.The endoscopic features,demographic characteristics,and clinical manifestations of the two patient groups were compared,and a logistic regression model was used to analyze the risk factors for HGIN in these patients.RESULTS The HGIN group was older and had a higher number of sigmoid colon polyps,rectal polyps,pedunculated polyps,polyps≥1.0 cm in size,polyps with surface congestion,polyps with surface depression,and polyps with villous/tubular adenomas,a higher proportion of patients with diabetes and a family history of colorectal cancer,patients who experienced rectal bleeding or occult blood,patients with elevated carcinoembryonic antigen(CEA)and cancer antigen 199(CA199),and lower nutritional levels and higher frailty levels.The polyp location(in the sigmoid colon or rectum),polyp diameter(≥1.0 cm),pathological diagnosis of(villous/tubular adenoma),family history of colorectal cancer,rectal bleeding or occult blood,elevated serum CEA and CA199 levels,lower nutritional levels and higher frailty levels also are independent risk factors for HGIN.CONCLUSION The occurrence of high-grade neoplastic transformation in colorectal polyps is closely associated with their location,size,villous/tubular characteristics,family history,elevated levels of tumor markers,and lower nutritional levels and higher frailty levels.

Missed diagnosis of early gastric cancer or high-grade intraepithelial neoplasia

AIM: To investigate the causes of missed diagnosis of early gastric cancer (EGC) or high-grade intraepithelial neoplasia (HGIN) in Chongqing, China. METHODS: The present study summarizes 103 cases of EGC/HGIN detected by esophagogastroduodenos-copy (EGD) and pathological analysis from January 2010 to December 2011. Dimethyl silicone oil was administrated orally 15 min before the EGD procedures. The stomach was cleaned by repeated washing with saline when the gastroscope entered the stomach cavity. Suspected EGC lesions were subject to conventional biopsy sampling and pathological examinations. The correlation between lesion locations, endoscopic morphology of cancerous sites, training level of the examiners, pathological biopsies, and missed diagnosis was analyzed. RESULTS: Twenty-three cases were missed among the 103 cases (22.23%) of EGC/HGIN. The rate of missed EGC in the gastroesophageal junction (8/19, 42.1%) was significantly higher than at other sites (15/84, 17.86%) (χ2 = 5.253, P = 0.022). In contrast, the rate of missed EGC in the lower stomach body (2/14, 14.29%) was lower than at other sites (21/89,23.6%), but there were no significant differences (χ2 = 0.289, P = 0.591). The rate of missed EGC in the gastric antrum (5/33, 15.15%) was lower than at other sites (18/70, 25.71%), but there were no significant differences (χ2 = 1.443, P = 0.230). Endoscopists from less prestigious hospitals were more prone to not diagnosing EGC than those from more prestigious hospitals (χ2 = 4.261, P = 0.039). When the number of biopsies was < 4, the rate of missed diagnosis was higher (20/23, 89.96%) than for when there were > 4 biopsies (3/23, 13.04%) (P < 0.001). In addition, there was no significant difference in the rate of missed diagnosis in patients with 1-3 biopsy specimens (χ2 = 0.141, P = 0.932). CONCLUSION: Endoscopists should have a clear understanding of the anatomical characteristics of the esophagus/stomach, and endoscopic identification of early lesions increases with the number of biopsies.

Multiple therapeutic and preventive effects of 3,3'-diindolylmethane on cancers including prostate cancer and high grade prostatic intraepithelial neoplasia

Cruciferous vegetables belong to the plant family that has flowers with four equal-sized petals in the pattern of a crucifer cross.These vegetables are an abundant source of dietary phytochemicals,including glucosinolates and their hydrolysis products such as indole-3-carbinol（I3C） and 3,3＇-diindolylmethane（DIM）.By 2013,the total number of natural glucosinolates that have been documented is estimated to be 132.Recently,cruciferous vegetable intake has garnered great interest for its multiple health benefits such as anticancer,antiviral infections,human sex hormone regulation,and its therapeutic and preventive effects on prostate cancer and high grade prostatic intraepithelial neoplasia（HGPIN）.DIM is a hydrolysis product of glucosinolates and has been used in various trials.This review is to provide an insight into the latest developments of DIM in treating or preventing both prostate cancer and HGPIN.

High-dose dietary zinc promotes prostate intraepithelial neoplasia in a murine tumor induction mode

To evaluate the role of high-dose dietary zinc in the process of prostate malignancy,60 Sprague-Dawley rats were randomly divided into four groups：tumor induction with carcinogen and hormone （group 1）,oral zinc administration without tumor induction （group 2）,oral zinc administration with tumor induction （group 3） and a control without zinc administration or tumor induction （group 4）. Zinc was supplied orally in the form of zinc sulfate heptahydrate dissolved in drinking water to groups 2 and 3 for 20 weeks. Although the serum level of zinc measured at 20 weeks was maintained similarly in each group （P = 0.082）,intraprostatic zinc concentrations were statistically different. Group 1 prostates contained the least amount of zinc in both the dorsolateral and ventral lobes at levels of 36.3 and 4.8 μg g^-1,respectively. However,in group 3,zinc levels increased in both lobes to 59.3 and 12.1 μg g^-1,respectively,comparable with that of group 4 （54.5±14.6 and 14.1±2.4 μg g^-1）. In spite of these increases in zinc concentration,the prevalence of prostate intraepithelial neoplasm was rather increased in group 3 （53.3% and 46.7%） compared with group 1 （33.3% and 33.3%） in both dorsolateral and ventral prostate lobes. Although prostate intraepithelial neoplasm did not develop in any prostate in group 4,zinc administration did induce prostate intraepithelial neoplasm in group 2 （46.7% and 40.0%）. Thus,although high dietary zinc increased intraprostatic zinc concentrations,it promoted,instead of preventing,prostate intraepithelial neoplasm in a murine prostate malignancy induction model.

Determination of an Appropriate Endoscopic Monitoring Interval for Patients with Gastric Precancerous Conditions in China

Objective Gastric precancerous conditions such as atrophic gastritis(AG)and intestinal metaplasia(IM)are considered independent risk factors for gastric cancer(GC).The suitable endoscopic monitoring interval is unclear when we attempt to prevent GC development.This study investigated the appropriate monitoring interval for AG/IM patients.Methods Totally,957 AG/IM patients who satisfied the criteria for evaluation between 2010 and 2020 were included in the study.Univariate and multivariate analyses were used to determine the risk factors for progression to high-grade intraepithelial neoplasia(HGIN)/GC in AG/IM patients,and to determine an appropriate endoscopic monitoring scheme.Results During follow-up,28 AG/IM patients developed gastric neoplasia lesions including gastric low-grade intraepithelial neoplasia(LGIN)(0.7%),HGIN(0.9%),and GC(1.3%).Multivariate analysis identified H.pylori infection(P=0.022)and extensive AG/IM lesions(P=0.002)as risk factors for HGIN/GC progression(P=0.025).Conclusion In our study,HGIN/GC was present in 2.2%of AG/IM patients.In AG/IM patients with extensive lesions,a 1–2-year surveillance interval is recommended for early detection of HIGN/GC in AG/IM patients with extensive lesions.

前列腺特异性膜抗原在前列腺癌中的表达及临床意义

目的研究前列腺特异性膜抗原(PSMA)在前列腺癌中的表达及其与Gleason分级之间的关系,同时探讨其在前列腺癌诊断中的价值。方法采用免疫组化EnVision法检测PSMA在前列腺癌、前列腺上皮内瘤变(PIN)和良性前列腺增生症(BPH)中的表达。结果PSMA在BPH、PIN和前列腺癌中均表达。在BPH中,PSMA阳性表达部位在前列腺腔缘或顶端/胞质表达,而在PIN中表达模式为胞质伴胞膜阳性,前列腺癌为顶端/胞质、胞质伴胞膜阳性或胞质表达阳性。PSMA在分化差前列腺癌中多为胞质表达,而在分化好的癌中为顶端/胞质和胞质伴胞膜表达。PSMA表达强度在PIN和前列腺癌中明显高于BPH(P<0.05),同时PSMA染色强度与Gleason评分呈正相关(P<0.05)。结论PSMA与Gleason分级密切相关,PSMA表达模式和染色强度的改变对PIN和前列腺癌诊断具有参考价值。

单纯前列腺上皮内瘤临床和病理特征分析——附23例报告

目的：探讨单纯前列腺上皮内瘤（prostatic intraep ithelial neop lasia,PIN）的临床和病理特征。方法：对23例低度（PIN 1级）PIN（低度组）和8例高度（PIN 2～3级）PIN（高度组）的临床资料进行数理分析,并以同期确诊为前列腺癌、BPH患者作为对照,分析上述各组患者临床和病理特征的差异。结果：高度组的血清总前列腺特异性抗原水平与低度组及BPH组比较差异均有统计学意义（均为P〈0.05）、前列腺特异性抗原密度与低度组比较差异有统计学意义（P〈0.05）。前列腺癌组的总前列腺特异性抗原、游离前列腺特异性抗原水平,前列腺体积及前列腺特异性抗原密度与其他3组比较差异均有统计学意义（P〈0.05～0.01）。免疫组织化学结果示低度PIN的特征类似于BPH而与前列腺癌有所不同,而少数（1/16）高度PIN患者的肿瘤标志物p504 s呈阳性。结论：低度PIN的临床和病理特征与BPH相似,而高度PIN的临床和病理方面具有一定的前列腺恶性肿瘤特征,需要积极进行临床追踪观察。

肿瘤标记物P504s在前列腺癌中的表达及应用价值

目的探讨肿瘤标记物P504s在不同前列腺组织中的表达情况,及在诊断前列腺癌中的应用价值。方法采用免疫组化二步法,观察P504s和基底细胞标记物p63在不同前列腺病变组织中的表达情况。结果①P504s表达在前列腺癌根治标本、高等级上皮内瘤标本、前列腺增生标本中的阳性率分别为91.4%(32/35)、87.0%(20/23)和0(0/30),良恶性组织的差别有显著性,在前列腺癌穿刺标本中阳性率85.7%(72/84)。p63染色在全部前列腺癌中呈阴性,在高等级上皮内瘤中为不连续或连续的阳性染色,在前列腺增生中为连续的阳性染色。②P504s表达与前列腺癌的分化程度、激素治疗、转移有关。结论P504s是一个特异的前列腺癌标记物,结合p63在鉴别诊断前列腺癌中有重要的临床应用价值。

前列腺癌中E-钙粘素、p16及雌激素受体基因甲基化的检测及其临床意义

目的:研究前列腺病变中E-钙粘素、p16和雌激素受体(ER)基因启动子CpG岛甲基化状况及其与临床资料的关系,探讨基因过甲基化在前列腺癌(PCa)发生发展中的作用及其临床意义。方法:收集石蜡包埋前列腺全切术标本:良性前列腺增生(BPH)13例,高级别前列腺上皮内瘤(HGPIN)10例,有随访记录的PCa 20例。采用甲基化特异性PCR(MSP)技术对E-钙粘素、p16和ER基因CpG岛甲基化进行检测。结果:E-钙粘素、p16和ER基因过甲基化在PCa中的发生率分别为30%、25%和65%。非恶性病变(BPH和HGPIN)很少发生DNA过甲基化。结论:PCa的发生及进展与E-钙粘素、p16和ER基因过甲基化密切相关,检测甲基化状况对HGPIN与PCa的鉴别诊断可能有辅助作用。E-钙粘素和ER基因过甲基化可能提示预后差。

人端粒酶逆转录酶在良性前列腺增生、前列腺上皮内瘤及前列腺癌中的表达及其意义

目的:探讨人端粒酶逆转录酶在良性前列腺增生、前列腺上皮内瘤及前列腺癌组织中的原位表达及其意义。方法:收集良性前列腺增生15例、前列腺上皮内瘤11例及前列腺癌17例。应用免疫组织化学法检测组织中人端粒酶逆转录酶的原位表达,分析良性前列腺增生、前列腺上皮内瘤及前列腺癌中的表达差异并探讨Gleason评分与人端粒酶逆转录酶表达强度的相关性。统计学分析采用Fisher确切概率法和Spearman秩相关分析。结果:人端粒酶逆转录酶的阳性表达率差异在良性前列腺增生组与前列腺癌组间有统计学意义(0%vs 88.24%,P<0.001);在前列腺上皮内瘤组与前列腺癌组间有统计学意义(36.36%vs 88.24%,P=0.01);在前列腺上皮内瘤组与良性前列腺增生组间也有统计学意义(36.36%vs 0%,P=0.022)。Gleason评分与人端粒酶逆转录酶表达强度呈正相关(P<0.05)。结论:人端粒酶逆转录酶在前列腺组织中的高表达,对于鉴别病变的良恶性具有重要意义;人端粒酶逆转录酶在前列腺癌中的表达强度随着Gleason评分的增加而呈现增强趋势;而人端粒酶逆转录酶在前列腺上皮内瘤中表达阳性的患者应列为密切的临床监控对象。

前列腺囊腺瘤临床病理观察

目的探讨前列腺囊腺瘤的临床病理特点、诊断与鉴别诊断、治疗与预后。方法分析1例前列腺囊腺瘤伴高级别上皮内瘤变的临床特征、影像学表现、组织学形态及免疫表型,并复习相关文献。结果患者男性,69岁,排尿排便不畅1年。MRI示盆腔巨大团块状囊实性信号,多发条索状分隔,分隔上见1.6 cm×1.4 cm大小、DWI高信号、ADC低信号、可强化的软组织影。术中见肿瘤与前列腺紧密粘连,剖开肿瘤呈多房囊性,囊壁大部分光滑,局部颗粒状,1.5 cm×1 cm大小,厚0.3 cm^0.4 cm。病理检查囊壁被覆PSA(+)、P504S(-)的立方或柱状上皮,颗粒状区域呈稍密集乳头状,细胞有异型,核仁小至中等大小,Ki-67增高,p53阳性。结论前列腺囊腺瘤是前列腺来源的罕见良性肿瘤,易误诊为苗勒管囊肿、囊状淋巴管瘤、前列腺囊肿等。肿瘤可伴发高级别上皮内瘤变,甚至癌变,病理检查需结合影像学表现充分取材。治疗以手术完整切除为主,伴高级别上皮内瘤变或癌变者预后有待长期观察。

活化白细胞粘附分子在前列腺上皮内瘤和前列腺癌中的表达及意义

目的 :探讨活化白细胞粘附分子 (ALCAM)在前列腺上皮内瘤 (PIN)和前列腺癌中的表达及与前列腺癌临床病理特征的关系。 方法 :用免疫组化EnVisionTM方法检测ALCAM蛋白在 4 1例前列腺癌和癌旁PIN、良性腺上皮的表达情况。 结果 :ALCAM在前列腺腺上皮普遍表达 ,在大部分PIN和低分化的前列腺癌表达增加 ,在部分高分化前列腺癌出现表达降低。ALCAM蛋白表达与前列腺癌病理分级相关 ,与术前血清前列腺特异性抗原水平、肿瘤分期无相关性。 结论 :ALCAM在PIN和前列腺癌中存在表达紊乱 ,提示ALCAM在前列腺癌发生发展中起一定作用。

慢性前列腺炎及多灶型HGPIN患者再次穿刺时发展为前列腺癌风险的研究

目的探讨伴有慢性前列腺炎及多灶型高级别前列腺上皮内瘤(Widespread high grade prostatic intraepithelial neoplasia,wHGPIN)患者再次活检,发展为前列腺癌风险的研究。方法 2006年7月—2014年12月收集前列腺再次穿刺活检者172例,均为初次活检病理诊断为HGPIN者,穿刺为经直肠超声引导下前列腺12点穿刺法。再次穿刺均是在初次穿刺6个月后进行的。多灶型HGPIN界定为在前列腺活检中有2针及以上检出高级别前列腺上皮内瘤,孤立型HGPIN界定为在前列腺活检中有1针检出高级别前列腺上皮内瘤。结果初次活检172例HGPIN患者,孤立型HGPIN 102例,伴有慢性前列腺炎患者17例;多灶型HGPIN 70例,伴有慢性前列腺炎患者54例;172例HGPIN患者再次活检病理为前列腺腺癌者48例,多灶型HGPIN组检出率52.86%(37/70),孤立型HGPIN组检出率为10.78%(11/102),差异有统计学意义(P<0.001);多灶型HGPIN伴有慢性前列腺炎组前列腺腺癌检出率高于不伴有慢性前列腺炎组,差异有统计学意义(P=0.011)。经Logistic回归模型分析,慢性前列腺炎和多灶型HGPIN是再次活检为前列腺癌的独立风险因素。结论首次活检为慢性前列腺炎与多灶型HGPIN患者是再次活检为前列腺腺癌的高风险因素,建议超声引导下经直肠前列腺再次活检。

前列腺上皮内瘤基底细胞变化的形态学观察

目的探讨前列腺上皮内瘤基底细胞的病变特点,为前列腺良恶性上皮病变的诊断及鉴别诊断提供依据。方法收集28例前列腺(高级别)上皮内瘤标本,应用光镜、免疫组化EliVision Plus二步法,选择34βE12、p63、P504S、PSA、PSAP抗体检测,观察前列腺上皮内瘤中基底细胞的缺失情况。结果HE切片中28例前列腺上皮内瘤的基底细胞变化难以确定,但免疫组化显示6例前列腺上皮内瘤病灶周围基底细胞几乎完全缺失,14例基底细胞断续存在,8例病灶周围基底细胞完整。6例基底细胞几乎完全缺失病例P504S阴性。肿瘤细胞P504S阳性4例,均为基底细胞断续存在病例。结论前列腺上皮内瘤中的基底细胞尽管多数较完整存在,但也存在一定比例的缺失,提示在日益增多的前列腺穿刺标本中,基底细胞完整并非是前列腺上皮内瘤诊断的最重要指标。

前列腺上皮内肿瘤与前列腺癌的病理形态学研究

目的：探讨前列腺上皮内肿瘤（ＰＩＮ）与前列腺癌的关系。方法：用常规ＨＥ染色、免疫组化、电镜方法，对１１３例前列腺标本进行形态学研究。结果：（１）ＰＩＮ由分泌细胞异型增生所致，其１、２级基底细胞及基底膜完整，３级则为局限性缺失和断裂。（２）ＰＩＮ检出率在前列腺癌例中明显高于非癌例中，癌旁高于远癌区，提示与癌关系密切。（３）免疫组化对ＰＩＮ的分级、ＰＩＮ与癌的鉴别有意义。（４）利用电镜观察癌细胞微足状浸润，对前列腺癌的早期浸润和诊断有价值。结论：ＰＩＮ为前列腺的癌前病变。

三叶因子1和3在前列腺癌及前列腺上皮内瘤中的表达及临床意义

目的:探讨三叶因子1(TFF1)及三叶因子3(TFF3)在前列腺癌(PCa)及前列腺上皮内瘤(PIN)中的表达及其临床意义。方法:采用免疫组化法检测89例前列腺癌(PCa)、50例PIN及65例癌旁良性前列腺增生(BPH)组织中TFF1及TFF3的表达情况。结果:TFF1和TFF3在PCa和PIN中的阳性表达率分别为77.53%、48.31%和66.00%、30.00%,显著高于癌旁BPH组织中表达率(分别为49.23%和13.85%,P<0.05),TFF1与PCa Gleason评分无关(P>0.05),TFF3在Gleason评分≤7分PCa组中阳性率(70.00%)高于Gleason评分>7分组(42.03%),差异有统计学意义(P<0.05)。TFF1和TFF3在PCa中的表达无相关性(P>0.05)。结论:TFF1和TFF3可能与PCa的发生有关,并对PCa可能起促进作用,两者有望成为PCa的诊断、鉴别诊断及预后的检测指标。

p38MAPK在前列腺癌发生中的作用

目的探讨丝裂素活化蛋白激酶p38(p38MAPK,p38)在前列腺癌发生、发展中的作用。方法采用免疫组织化学SP法对良性前列腺增生(BPH)、前列腺上皮内瘤(PIN)和早期前列腺癌(Pca)各12例石蜡标本中p38表达情况进行检测。结果在BPH、PIN和Pca组织中,p38活性表达呈递增趋势,三组之间两两比较,均有显著性差异(P<0.05)。结论p38级联途径的激活参与了前列腺上皮的恶性转化,可能在PIN和Pca的发生和发展过程中起重要作用。

EGFR及TGF-α在前列腺腺癌及前列腺上皮内瘤组织中的表达及其临床意义

目的:探讨表皮生长因子受体(EGFR)和转化生长因子α(TGF-α)蛋白在前列腺腺癌(PAC)和高级别前列腺上皮内瘤(HGPIN)以及癌旁前列腺良性增生(BPH)组织中的表达,阐明其表达在PAC发生过程中的作用。方法:收集41例PAC和癌旁BPH组织以及32例HGPIN病变组织,采用免疫组化SABC方法检测EGFR和TGF-α在不同病变中的表达。结果:①EGFR在PAC、HGPIN及BPH组织中的阳性表达率分别为56.6%、53.7%及85.4%,在BPH中的表达率高于PAC和HGPIN,差异有统计学意义(P<0.01)。PAC和HGPIN组织中EGFR的表达差异无统计学意义(P>0.05)。EGFR的表达与肿瘤细胞的分化程度无关,在高、中和低分化PAC组织中阳性表达率分别为53.9%、55.6%及52.6%,差异无统计学意义(P>0.05)。②TGF-α在PAC中的阳性表达率为56.1%,在癌旁BPH组织中阳性表达率为85.4%,差异有统计学意义(P<0.01),但与肿瘤细胞的分化程度无关,在高、中和低分化PAC阳性表达率分别为53.8%、66.7%及52.6%,差异无统计学意义(P>0.05)。③TGF-α在HGPIN病变中的阳性表达率为56.3%,与PAC比较差异无统计学意义(P>0.05),但与BPH比较差异有统计学意义(P<0.01)。EGFR和TGF-α在PAC中共同阳性率为81.8%,分别阳性率EGFR为18.2%,TGF-α为26.3%,两者呈正相关(r=0.558,P<0.001),但在HGPIN病变(r=0.111,P=5.450)和BPH(r=0.024,P=0.883)中两者无相关性。结论:EFFR和TGF-α蛋白在PAC、HGPIN和BPH组织中的表达水平不同,可以作为良恶性前列腺疾病的诊断及鉴别诊断指标。

免疫组化P504S、p63、34βE12在前列腺病变组织中的表达

目的探讨P504S、p63、34βE12在前列腺病变组织中的表达,以评估其在鉴别诊断中的意义。方法应用免疫组化PV9000二步法检测43例前列腺腺癌、27例前列腺重度上皮瘤变、40例前列腺结节性增生组织中P504S、p63、34βE12的表达情况。结果P504S在前列腺癌性腺体与重度上皮瘤变、前列腺结节性增生腺体组织中的阳性表达率之间均有非常显著性差异(P<0.01);但在Gleason评分分值显示,不同的前列腺腺癌组织中的表达无显著性差异(P>0.05);p63、34βE12在所有前列腺癌腺体组织中均呈阴性,在重度上皮瘤变组织中呈弱阳性、阳性或强阳性,在前列腺结节性增生组织中均呈强阳性。结论P504S是前列腺腺癌敏感而特异性的标志物,其与p63、34βE12联合标记在前列腺病变的鉴别诊断中具有重要意义,为临床早期发现、早期治疗前列腺腺癌提供了有力的理论依据。