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目的:观察α-甲基-辅酶A-消旋酶(alpha-methylacyl-CoA racemase,P504S)、角蛋白-903(34βE12)、P63及前列腺特异性抗原(prostate-specific antigen,PSA)在不同性质前列腺穿刺标本中的表达特点,探讨它们在前列腺癌病理诊断及鉴别诊断中的意义。方法:收集中南大学湘雅二医院前列腺穿刺活检标本238例,其中前列腺癌140例,前列腺转移性癌10例,良性前列腺增生72例,前列腺高级别上皮内瘤16例。采用免疫组织化学方法检测P504S,34βE12,P63及PSA在前列腺病变中的表达情况。结果:P504S在前列腺癌中呈高表达(阳性率91.43%),在其他3种组织中均表达很低(P<0.05);34βE12与P63在前列腺癌中阳性率(1.42%)均低于高级别前列腺上皮内瘤及前列腺增生(分别为93.75%和97.22%,P<0.05);PSA除在前列腺转移癌中呈阴性表达外,在其他3种组织均为阳性。结论:联合检测P504S,34βE12,P63及PSA,并结合病理形态综合分析,才能有助于前列腺癌的确诊。
OBJECTIVE: To observe the effects of alpha-methylacyl-CoA racemase (P504S), keratin-903 (34βE12), P63 and prostate-specific antigen (PSA) Prostate puncture specimens in the expression characteristics, to explore their significance in the pathological diagnosis of prostate cancer and differential diagnosis. Methods: 238 cases of prostate biopsy specimens from Xiangya Second Hospital of Central South University were collected, including 140 cases of prostate cancer, 10 cases of metastatic prostate cancer, 72 cases of benign prostatic hyperplasia and 16 cases of high grade intraepithelial neoplasia of prostate. Immunohistochemistry was used to detect the expression of P504S, 34βE12, P63 and PSA in prostatic lesions. Results: P504S was highly expressed in prostate cancer (positive rate was 91.43%), while it was low in other three tissues (P <0.05). The positive rate of 34βE12 and P63 in prostate cancer was 1.42% Grade prostatial intraepithelial neoplasia and benign prostatic hyperplasia (93.75% and 97.22%, respectively, P <0.05). PSA was negative in all three tissues except prostate cancer. Conclusion: Combined detection of P504S, 34βE12, P63 and PSA, combined with pathological morphological analysis, can be helpful for the diagnosis of prostate cancer.