前列腺穿刺活检临床病理及免疫组化诊断前列腺癌的研究

目的探讨P504s、p63、Ki67抗体在前列腺穿刺活检组织中表达检测在前列腺癌（PCa）诊断中的应用价值。方法回顾性分析232例行前列腺穿刺活检的患者的临床资料，对穿刺活检标本行HE切片观察和P504s、p63、Ki67免疫组化染色检测。结果232例患者中PCa42例，前列腺高级别上皮内瘤变（HGPIN）18例，前列腺低级别上皮内瘤变（LGPIN）35例，前列腺非典型腺瘤性增生（AAH）12例，良性前列腺增生症（BPH）125例。PCa、HG．PIN中的P504s的阳性率与LGPIN、AAH、BPH相比有显著性差异（P均〈0．01），但PCa与HGPIN比较无显著性差异（P均〉0．05）。p63在PCa中无表达，与HGPIN、LGPIN、AAH、BPH比较有显著性差异（P均〈0．01）。Ki67在PCa中的表达显著高于HGPIN、LGPIN、AAH、BPH（P均〈0．05）。PCaKi67的表达强度与Gleason分级显著相关（P〈0．01），而PCaP504s的表达强度与Gleason分级无显著相关性（P〉0．05）。结论前列腺穿刺活检是诊断前列腺癌的可靠方法，P504s、p63、Ki67联合检测在前列腺癌诊断和鉴别诊断中有重要的应用价值。Ki67可以作为判断前列腺癌生物学行为及预后的重要参考指标。

Study on the diagnosis of prostate cancer by needle biopsy for clinical pathology and immunohistochemisty

Objective It is to approach the applied value of the expression detection of P504s, p63 and Ki67 antibody in prostate needle biopsy for the diagnosis of prostate cancer （ PCa）. Methods Clinical data of 232 patients who encountered prostate needle biopsy were analyzed retrospectively, and the biopsy specimens were performed with HE - section observation and treated with P504s, p63, Ki67 immunohistoehemieal staining. Results The number of cases with PCa, high grade intraepithelial neoplasia （HGPIN） , low grade intraepithelial neoplasia （LGPIN） , atypical adenomatous hyperplasia （AAH） and benign prostatic hyperplasia （BPH） were 42, 18, 35, 12 and 125 respectively. There were significant difference between the positive rate of the PCa and HGPIN compared with LGPIN, AAH and BPH （ all P 〈 0.01 ） , but was not between P504S compatred with PCa and HGPIN （ all P 〉 0.05 ）. The p63 was negative in PCa, and the positive rate of p63 in the PCa was signifi- cantly lower than that of HGPIN, LGPIN, AAH, BCH and BPH （ all P 〈 0.05 ）. The positive rate of Ki67 in PCa was significantly higher than that of HGPIN, LGPIN, AAH and BPH （ all P 〈 0.05 ）. The expression intensity of Ki67 was correlated with Gleason grade in PCa. With gradual escalation of Gleanson grade, Ki67 expression intensity in tumor cells tends to rise. The expression intensity of P504s was not significantly correlated with the Gleanson grade in PCa （ P 〉 0.05 ）. Conclusion Prostate needle biopsy is a reliable method for the diagnosis of PCa. Combined detection of P504S, p63 and Ki67 has important application value in the diagnosis and differential diagnosis of PCa. Ki67 can be used as an important indicator to judge the biological behavior and PCa prognosis.