AMACR联合P63或CK34βE12在前列腺癌诊断和鉴别诊断中的应用

目的评价AMACR联合P63或CK34βE12在前列腺癌(PC)诊断和鉴别诊断中的应用价值。方法应用免疫组化SP法检测了73例前列腺病变标本前列腺癌、良性前列腺增生(BPH)、高级别前列腺上皮内瘤(HGPIN)、低级别前列腺上皮内瘤(LGPIN)和非典型腺瘤样增生(AAH)]中AMACR、P63和CK34βE12的表达情况。结果①AMACR在PC中阳性率为96.43%(27/28),在HGPIN、LGPIN、AAH和BPH中阳性率分别为83.33%(10/12)、11.11%(1/9)、16.67%(1/6)和0。癌组化明显高于LGPIN、AAH和BPH(P<0.001),与HGPIN之间无差异(P=0.209);②P63和CK34βE12在BPH、LGPIN和AAH中全部为阳性染色,而在PC中全部为阴性。P63和CK34βE12在HGPIN中的阳性率分别为83.33%(10/12)和91.67%(11/12)。癌组化低于HGPIN等其他病变(P<0.001);③AMACR阳性协同P63或CK34βE12阴性两种标记在PC中表达率为96.4%,HGPIN为8.33%,LGPIN、AAH和BPH为0。癌组化明显高于HGPIN等其他病变(P<0001)。结论AMACR是PC较高的敏感特异性瘤标,AMACR联合P63或CK34βE12的检测对PC的诊断和鉴别诊断有较好的应用价值。

Application of AMACR combined with P63 or CK34βE12 in diagnosis and differentiation of prostate adenocarcinoma

Objective To evaluate the application of AMACR combined with P63 or CK34βE12 in diagnosis and differentiation of prostate adenocarcinoma. Methods AMACR, P63 and CK34βE12 immunohistochemistry were applied in 73 cases of prostatic adenocarcinoma(PC) ,high-grade prostatic intraepithlial neoplasia(HGPIN) , low-grade prostatic intraepithlial neoplasia(LGPIN) , atypical adenomatous (AAH) and benign prostatic hyper plasia (BPH). Results ①27 of the 28(96. 43%) cases of PC and10 of the 12 (83. 33%) cases of HGPIN stained positive for AMACR, with strong staining in most cases. In LGPIN (11.11% ,1/9) , AAH(16.7% ,1/ 6) , and BPH(0) ,the positive expression rates were significantly lower than that of PC(P<0. 001). However, there was no significant difference between PC and HGPIN(P = 0.209) . ② All 28 carcinoma cases showed negative for P63 or CK34βE12 and BPH, AAH, LGPIN showed positive for P63 or CK34βE12 too. Expression of P63 or CK34βE12 was demonstrated in HGPIN at frequencies of 10/12(83.33%) and 11/12(91.67%), respectively. There was significant difference in P63 or CK34βE12 expression between PC and HGPIN, LGPIN, AAH,BPH(P<0.001). ㏕he AMACR positive expression combined with the P63 or CK34βE12 negative expression was demonstrated in PC at the rate of 96.43% , HGPIN, 8.33% . All of BPH, AAH, LPIN showed negative for AMACR combined with P63 or CK34βE12. Conclusion AMACR is a useful tumor marker for diagnosis of prostatic adenocarcinoma. The application of AMACR combined with P63 or CK34βE12 may be of greater benefit in diagnosing and differentiating prostate adenocarcinoma.