丝裂素活化蛋白激酶激酶在前列腺上皮内瘤组织中的表达及意义

丝裂素活化蛋白激酶激酶 (ＭＥＫ)是丝裂素活化蛋白激酶 (ＥＲＫ)信号传递途径中主要成员之一 ,直接影响ＥＲＫ的活性 ,对细胞增殖起重要作用。我们采用免疫组化方法研究了ＭＥＫ在前列腺上皮内瘤 (ＰＩＮ)中的表达。材料与方法　 12例ＰＩＮ标本为 1994～ 1998年我院手术存档标本。患者平均年龄 66岁。其中 4例行经尿道前列腺切除术 ,8例行耻骨上前列腺切除术。10例良性前列腺增生标本作为对照组 ,患者平均年龄 64岁。所有标本均重新进行病理诊断。ＭＥＫ一抗为兔抗人多克隆抗体 (ｓａｎｔａｃｒｕｚ公司 )。免疫组织化学采用ＳＰ法。阳性…     

上皮特异性粘附分子在前列腺癌中的表达及意义

目的:探讨上皮特异性粘附分子(Ep CAM)在前列腺癌(PCa)中的表达及其临床意义。方法:选取63例PCa、46例前列腺上皮内瘤(PIN)及58例癌旁良性前列腺增生(BPH)标本,采用免疫组化染色法观察EpCAM在上述组织的上皮细胞及间质细胞中的表达情况。结果:Ep CAM在PCa和癌旁PIN的上皮细胞中的阳性表达率高于癌旁BPH(98.4%、97.8%vs 51.7%,P0.01),并且在PCa的间质细胞中的阳性表达率(89.5%)高于在癌旁PIN(50.0%,P0.01)。Ep CAM在有骨转移组织的间质细胞阳性表达率(100.0%)明显高于无骨转移组织(40.0%,P0.01),但是在PCa高中分化组和低分化组中的阳性表达率无明显差异(88.5%vs 91.9%,P0.05)。结论:Ep CAM在PCa的间质细胞中的表达与前列腺癌的发生、发展及骨转移有关,有望成为PCa的早期诊断标准及PCa骨转移的预测指标。     

前列腺上皮内瘤的临床意义及处理

前列腺上皮内瘤 (PIN)是前列腺导管、小管及腺泡上皮细胞的异常增生。PIN分为Ⅰ、Ⅱ、Ⅲ级 ,Ⅰ级为低分级PIN ,Ⅱ和Ⅲ级为高分级PIN。临床上诊断为PIN是指高分级PIN ,低分级PIN不作为独立的病理诊断。高分级PIN被认为是前列腺癌的癌前病变。在流行病学、基因学、病理形态学、发生的部位及临床特点等 ,高分级PIN与前列腺癌都很相似 ,两者密切相关。高分级PIN是病理诊断 ,前列腺的直肠指检及B超检查无特异性 ,多数学者认为高分级PIN患者血清PSA并不升高 ,高分级PIN患者的血清PSA升高者 ,要考虑高分级PIN与前列腺癌共同存在的可能性。高分级PIN的处理尚无一致认同的意见 ,目前多数认为多针穿刺活检诊断为单纯高分级PIN的患者 ,可不进行任何治疗 ,但要定期随访复查 ,对PSA值升高或B超检查有异常改变者 ,再行穿刺活检。目前对高分级PIN的生物学行为所知甚少 ,多数学者不主张对单纯高分级PIN患者采用抗雄激素治疗。     

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%,P0.05),TFF1与PCa Gleason评分无关(P0.05),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(P0.05)。TFF1和TFF3在PCa中的表达无相关性(P0.05)。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。     

p53和bcl-2在人前列腺癌和高分级前列腺上皮内瘤细胞中的表达及意义

研究发现前列腺上皮内瘤 (ＰＩＮ)可能为人前列腺癌 (ＰＣａ)的前趋病变[1] 。我们采用免疫组织化学方法检测并比较ＰＣａ和高分级ＰＩＮ细胞中ｐ5 3和ｂｃｌ 2蛋白的表达 ,探讨人ＰＣａ的发生机制 ,报告如下。材料与方法　经病理证实的 12例高分级ＰＩＮ及 2 3例ＰＣａ石蜡包埋标本。两组患者年龄分别为 5 3～ 6 7岁和 5 7～78岁。ｐ5 3和ｂｃｌ 2蛋白表达的免疫组化分析方法参照文献 [2 ]。结果　 12例ＰＩＮ标本组织细胞中均有较强的ｂｃｌ 2蛋白表达而无ｐ5 3蛋白表达 ,2 3例ＰＣａ标本细胞中ｐ5 3和ｂｃｌ 2蛋白表达者分别为 6例和 5例…     

前列腺上皮内瘤患者穿刺及临床资料回顾性分析

目的：探讨前列腺上皮内瘤 （ prostatic intraepithelial neoplasia, PIN） 的临床及病理学特性。方法：回顾性分析561例行穿刺病理检查患者的临床资料,以同期病理诊断为前列腺癌（PCa）、良性前列腺增生（BPH）、低级别前列腺上皮内瘤（LPIN）和高级别前列腺上皮内瘤（HPIN）的患者做非随机对照研究,并对HPIN首次重复穿刺各组病理改变结果的临床资料进行对比分析。结果：PCa组分别与BPH、LPIN、HPIN各组不同血PSA浓度分布进行比较,结果差异均有统计学意义（P〈0．05）;其余各组间不同血PSA浓度分布比较差异均无统计学意义（P〉0．05）。HPIN组分别与LPIN组重复穿刺和BPH组重复穿刺或TURP病理检查结果中癌发现率进行比较,差异均有统计学意义（P〈0．05）;而BPH组与LPIN组比较差异则无统计学意义（P〉0．05）。HPIN首次重复穿刺各组病理改变的年龄、PSA、直肠指检（DRE）比较差异均无统计学意义。结论：PIN对血PSA的分布没有影响;LPIN的生物学倾向于良性;而HPIN具有一定癌变的风险性,应积极随访。     

细胞外信号调节蛋白激酶在前列腺上皮内瘤组织中的表达及意义

目的 探讨细胞外信号调节蛋白激酶（ERK）在前列腺上皮内瘤（PIN）组织中表达的意义。方法 应用免疫组织化学SP法检测12例PIN、11例前列腺癌（PCa)及16例BPH组织标本中ERK的表达。结果 12例PIN标本均有表达,其中6例为高表达;11例PCa组织10例为阳性,但多为弱表达;16例BPH组织12例为阳性,表达也较弱。PIN组织中ERK表达与PCa组和BPH相比ERK在PIN组织中呈高表达,与早期前列腺癌的发生有密切关系。     

高分级前列腺上皮内瘤预测前列腺癌的临床价值

目的研究高分级前列腺上皮内瘤（high grade prostatic introepithelial neoplasia，HGPIN）预测前列腺癌的临床价值。方法对243例经过前列腺特异性抗原、直肠指诊和经直肠超声（transrectal ultrasounds，TRus）检查出现异常的可疑前列腺癌患者行间隔1年为期2年的TRUS引导下的前列腺穿刺或经尿道前列腺电切，行组织活检及重复活检，对结果中存在HGPIN的实验组与无HGPIN的对照组进行分析研究。结果243例患者中失访2例，平均随访36个月。首次活检结果前列腺癌23例，其中伴HGPIN16例（69．6％）；HGPIN51例。第1次重复活检63例，诊断前列腺癌19例，其中伴HGPIN13例（68．4％），新发现HGPIN12例。第2次重复活检43例，前列腺癌11例，伴HGPIN7例（63．6％）；新发现HGPIN5例。实验组68例，对照组150例。前列腺癌伴HGPIN的发生率（67．9％）明显高于非前列腺癌患者（25．0％）（P〈0.05）。2组重复活检前列腺癌的检出率（实验组30．9％，对照组6．0％，P〈0.05）及2年无瘤生存率Log-Rank检验（P〈0.05）差异均有统计学意义。HGPIN诊断前列腺癌的敏感度和特异度的ROC检验P〈0．01，COX比例风险模型分析显示HGPIN是前列腺癌发生的危险因素。结论HGPIN与前列腺癌的发生有关，对诊断前列腺癌有预测价值。     

前列腺上皮内瘤

前列腺上皮内瘤(Prostatic intraepithelial neo-plasia,PIN)是公认的前列腺癌的癌前病变,是近几年前列腺癌的研究热点。PIN指的是前列腺导管、小管和腺泡上皮异常增生,是Bostwick和Bra-war于1987年首先提出的[1]。PIN分为两级,低分     

前列腺上皮内瘤与前列腺癌的相关性及诊治

近年来的临床研究发现,前列腺上皮内瘤(Prostatic intraepithelial neoplasia,PIN)与前列腺癌有关.目前,高分级PIN被视为前列腺癌的癌前病变,如果活检发现PIN,则提示有前列腺癌的可能,有必要进一步检查,以明确有无并存的前列腺癌.文献报告在前列腺癌病例中约85%同时伴有PIN.     

活化白细胞黏附分子在IgA肾病中的表达及意义

目的:探讨活化白细胞黏附分子(CD166)在IgA肾病中的表达及与IgA肾病临床病理特征的关系.方法:用免疫组化二步法检测CD166蛋白在79例IgA肾病患者肾组织的表达.结果:CD166在IgA肾病患者肾小管、间质普遍表达,按Lee分级的级别增加逐渐增高.与单纯性血尿患者(A组)相比,混合蛋白尿、血尿患者(B组)肾小管间质CD166表达明显增高.肾小管间质CD166表达与患者病理分级、小管间质病变、单个核细胞浸润程度及血清C反应蛋白(CRP)水平正相关.结论:CD166在IgA肾病中表达异常,在IgA肾病小管、间质病变及疾病进展中起一定作用.     

Prostatic Adenocarcinoma,Prostatic Intraepithelial Neoplasia,and Intraductal Carcinoma

Prostate carcinoma (PCa) exhibits a wide range of architectural and cytological features. Gleason grading remains as one of the most powerful histological prognostic parameters. However, it has evolved considerably. High-grade prostatic intraepithelial neoplasia (high-grade PIN) is accepted as a precursor lesion to PCa. Its detection in prostate biopsy is also considered as a risk factor for detecting cancer in subsequent biopsies. Such risk, however, has significantly decreased in recent studies. Intraductal carcinoma of the prostate (IDC-P) represents the intraductal spread of invasive cancer and constitutes a poor histologic parameter. This article reviews the key histological features of PCa, high-grade PIN and IDC-P, as well as the Gleason grading system that was most recently updated in 2005.     

高分级前列腺上皮内瘤研究进展

前列腺上皮内瘤(prostatic intraepithelial neoplasia,PIN)与前列腺癌密切相关,高分级PIN被认为是前列腺癌的癌前病变.在流行病学、基因学、病理形态学、发生的部位及临床特点等,高分级PIN与前列腺癌都很相似,两者密切相关.如果活检发现HGPIN,则提示有进展为前列腺癌的可能,有必要随访检查,以明确有无并存的前列腺癌.     

Significance of Perineural Invasion,Lymphovascular Invasion,and High-Grade Prostatic Intraepithelial Neoplasia in Robot-Assisted Laparoscopic Radical Prostatectomy

Background  

Recently, more detailed histopathological variables such as perineural invasion (PNI), lymphovascular invasion (LVI), and high-grade prostatic intraepithelial neoplasia (HGPIN) have been investigated as prognostic factors for adverse pathologic findings on the radical prostatectomy specimen. We aim to determine whether these pathological factors are associated with adverse pathologic features after robot-assisted laparoscopic radical prostatectomy (RALP).     

Paclitaxel Impairs Endothelial Cell Adhesion But Not Cytokine-Induced Cellular Adhesion Molecule Expression

Local delivery of antiproliferative agents using drug-eluting stents has become a productive area of research for preventing in-stent restenosis. Recently, the microtubule stabilizing drug paclitaxel has been used to coat stents. While the actions of paclitaxel on smooth muscle are well documented, effects on endothelial cells (ECs) are largely unknown. Nevertheless, restoration of EC function is a critical step in repairing the vascular lesion. We assessed the effects of paclitaxel by examining three events that are critical in controlling the severity of vascular injury: (1) adhesion of ECs to matrix proteins, (2) EC migration, and (3) cytokine-stimulated cellular adhesion molecule (CAM) expression on the surface of ECs. Paclitaxel inhibited both EC adhesion and migration of ECs; however, it had no effect on tumor necrosis-stimulated CAM expression on ECs. The mechanisms of paclitaxel action on matrix adhesion and migration are not clear, but protein kinase C and myosin light chain kinase do not appear to play a role as they are unaffected by treatment of the cells with paclitaxel. On the other hand, the MAP kinase ERK1/2 is modestly inhibited by paclitaxel. While paclitaxel-coated endovascular stents may prevent smooth muscle proliferation, their attenuation of EC migration and adhesion to the lesion coupled with an inability to reduce cytokine-induced CAM expression on ECs may limit their effectiveness.     

The Relationship Between Prostatic Intraepithelial Neoplasia and Prostate Cancer: Critical Issues

Purpose

Prostatic intraepithelial neoplasia (PIN) is often considered to be a premalignant lesion and the main precursor of invasive carcinoma of the prostate. We evaluated the evidence for and against PIN as a premalignant lesion and determined guidelines for the clinical management of PIN.

Materials and Methods

Literature analysis of histopathological, morphometric, phenotypic and molecular genetic evidence of progression and of clinical findings regarding PIN was done. Literature searches were performed on MEDLINE with relevant key words.

Results

PIN, like prostate cancer, occurs most frequently in the peripheral zone of the prostate and is usually located in close proximity to prostate cancer. The relative PIN and prostate cancer volumes vary inversely. Prostate specific antigen in cases of PIN appears to be intermediate between prostate cancer and normal levels, although this elevation may be explained by concomitant prostate cancer or benign prostatic hyperplasia. Deoxyribonucleic acid ploidy in PIN follows the aneuploid proportion as in the concomitant prostate cancer. Prostate cancer and PIN show evidence of loss of putative tumor suppressor genes on chromosome 8p.The clinical relevance of PIN biopsy findings is based on the association of neoplasia and prostate cancer. High grade PIN in core biopsies without concomitant prostate cancer has a substantial risk for prostate cancer in subsequent biopsies (24 to 73%, up to 100% when the digital rectal examination is suspicious) and should cause further biopsy sampling.

Conclusions

There is convincing evidence that PIN is a precursor lesion to prostate cancer, with a close association of PIN and prostate cancer in biopsy and prostatectomy specimens. A biopsy finding of high grade PIN necessitates further investigation in patients who are candidates for radical treatment for localized prostate cancer.