p63和p504S联合检测在前列腺肿瘤鉴别诊断中的应用

目的探讨p63和p504S联合免疫组化染色在前列腺良、恶性病变鉴别诊断中的价值。方法采用免疫组化方法，观察p63、p504S在不同前列腺疾病中的表达情况。结果大多数良性前列腺增生及低度PIN的腺泡和导管周围可见连续的p63（＋），少数呈间断表达，p504S染色皆呈（-）；高度PINp63染色呈不连续表达或（-），而增生的腺上皮，部分细胞p504S呈弱（＋）或（＋）；非典型腺瘤性增生p63呈（＋），p504S呈阴性反应；前列腺癌20例中19例p63染色呈（-），1例显示局灶性（＋），但p504S均呈（＋）。结论p63、p504S联合检测可极大地提高前列腺癌诊断的正确率。     

CK34βE12、p63和P504S联合检测在前列腺癌诊断中的应用

 目的 探讨CK34βE12、p63和P504S联合免疫组化标记在前列腺良、恶性病变鉴别诊断中的应用价值。方法 应用免疫组织化学方法，观察74例前列腺病变标本[包括前列腺癌（PC）27例、高级别前列腺上皮内瘤（HGPIN）6例、低级别前列腺上皮内瘤（LGPIN）10例、前列腺非典型腺瘤性增生（AAH）3例、良性前列腺增生（BPH）28例]中CK34βE12、p63和P504S的表达情况。结果 p63和CK34βE12在AAH、LGPIN和BPH中均为阳性染色，而在PC中均为阴性，在6例HGPIN中5例为阳性，PC组表达率明显低于其他病变组差异有统计学意义（P＜0.01）；P504S 在PC、AAH、HGPIN、LGPIN和BPH中阳性率分别为92.6 %（25／27）、0、66.7 %、10 %和0，PC组明显高于AAH、LGPIN和BPH组（P＜0.01），与HGPIN组之间差异无统计学意义（P = 0.132）；P504S阳性协同p63或CK34βE12阴性两种标记在PC、AAH、HGPIN、LGPIN和BPH中表达率分别为92.6 %、0、16.7 %、0和0，两种标记表达在前列腺癌与其他病变之间差异有统计学意义（P＜0.01）。结论 利用P504S与p63或CK34βE12联合检测有助于提高前列腺癌诊断的准确率。     

前列腺癌中 P504S、34βE12、p63 的检测及意义

目的:探讨P504S、p63、34βE12在前列腺腺癌中的表达和诊断意义.方法:应用免疫组化法观察30例前列腺癌(PCa)、49例良性前列腺增生(BPH)、6例不典型腺瘤样增生(AAH)和29例前列腺上皮内瘤变(PIN)组织中P504S、p63、34βE12的表达.结果:28例PCa阳性表达P504S,1例灶性阳性,5例PIN灶性阳性表达P504S;P504S在PCa组阳性明显高于BPH、AAH、和PIN组(P＜0.01),灶性阳性表达在两组之间无明显差异(P＞0.05).1例PCa灶性阳性表达p63和34βE12,49例BPH、4例AAH和26例PIN为p63和34βE12阳性,2例AAH和3例PIN为灶性阳性,PCa组p63和34βE12阳性表达明显低于其他病变组(P＜0.01),灶性阳性表达在两组之间无明显差异(P＞0.05).结论:P504S是前列腺癌敏感而特异性的标记物,合理利用P504S、p63、34βE12的检测,可提高前列腺癌的诊断准确率和检出率.     

前列腺癌中P504S、34βE12、p63的检测及意义

目的：探讨P504S、p63、34βE12在前列腺腺癌中的表达和诊断意义。方法：应用免疫组化法观察30例前列腺癌（PCa）、49例良性前列腺增生（BPH）、6例不典型腺瘤样增生（AAH）和29例前列腺上皮内瘤变（PIN）组织中P504S、p63、34βE12的表达。结果：28例PCa阳性表达P504S,1例灶性阳性,5例PIN灶性阳性表达P504S;P504S在PCa组阳性明显高于BPH、AAH、和PIN组（P〈0.01）,灶性阳性表达在两组之间无明显差异（P〉0.05）。1例PCa灶性阳性表达p63和34βE12,49例BPH、4例AAH和26例PIN为p63和34βE12阳性,2例AAH和3例PIN为灶性阳性,PCa组p63和34βE12阳性表达明显低于其他病变组（P〈0.01）,灶性阳性表达在两组之间无明显差异（P〉0.05）。结论：P504S是前列腺癌敏感而特异性的标记物,合理利用P504S、p63、34βE12的检测,可提高前列腺癌的诊断准确率和检出率。     

P504S和P63联合应用在前列腺增生与前列腺癌诊断中的意义

目的探讨P504S、P63在前列腺增生症、前列腺高级别上皮内瘤变（HGPIN）和前列腺癌中表达的意义。方法应用免疫组化Envision二步法检测一般前列腺增生症90例、HGPIN15例、前列腺癌20例组织中P504S、P63的表达情况。结果P504S、P63在一般前列腺增生症和前列腺癌中表达的阴阳性之间差异均有非常显著性。P504S在一般前列腺增生和HGPIN的表达也有非常显著的差异,其在HGPIN和前列腺癌的表达却差异无显著性。P63在一般前列腺增生和HGPIN的表达差异无显著性,在HGPIN和前列腺癌的表达却差异有显著性。结论P504S是前列腺癌敏感而特异性的标志物,需与P63联合应用,对前列腺疾病诸如前列腺增生、HGPIN以及前列腺癌的诊断具有重要价值。     

良性前列腺增生及前列腺癌的ADC值与PAP、P504S、PSA表达的相关性研究

目的：探讨良性前列腺增生和前列腺癌的ADC值与前列腺相关标志物PAP、P504S、PSA表达的关系。方法收集经病理证实的65例前列腺疾病患者,其中良性前列腺增生30例,前列腺癌35例。病理检查前3个月内均行前列腺MRI、DWI检查,采用单次激发EPI序列,b值为0 s/mm2和800 s/mm2,并采用免疫组化检测组织标本中PAP、P504S、PSA的表达,分析ADC值与PAP、P504S、PSA表达的关系。结果良性前列腺增生和前列腺癌的ADC值分别为（1.73±0.21）×10-3 mm2/s和（1.34±0.15）×10-3 mm2/s,差异具有统计学意义（t=8.545,P=0.000）。PAP和PSA在良性前列腺增生和前列腺癌中均表达,差异无统计学意义（P均＞0.05）,P504S在前列腺癌中的表达显著高于良性增生（Z=-7.055,P=0.000）,双变量相关分析显示ADC值与P504S的表达呈显著负相（Spearman's相关系数r=-0.654,P=0.000）;结论 PAP和PSA不能区别前列腺良恶性病变;P504S可以作为前列腺癌标志物;ADC值可以定量评价良性前列腺增生和前列腺癌,且与P504S存在负相关,可以作为前列腺良恶性病变MRI诊断的参考指标。     

P504S、p63、34βE12在前列腺不同病变诊断中的意义

目的 探讨P504S、p63、34βE12在良性前列腺增生、不典型腺瘤样增生、前列腺上皮内瘤变和前列腺腺癌诊断中的意义.方法 收集102例前列腺不同病变的常规石蜡标本,光镜下按WHO标准分类,应用免疫组织化学二步法,观察PS04s、p63、34βE12的表达.结果 良性前列腺增生、不典型腺瘤样增生的腺泡和导管周围34βE12和p63均为(+),而P504S均(-).低级别PIN及高级别PIN的腺泡和导管周围34βE12和p63均为(+),而增生的腺上皮P504S分别为7.7%(2/26)、33.3%(1/3)呈局灶性阳性.前列腺腺癌18例中,34βE12和p63均为(-),P504S有2例呈局灶性阳性(11.1%),15例P504S呈阳性(83.3%).结论 P504S是前列腺腺癌敏感而特异性的标记物,联合检测PS04S、p63、34βE12可提高前列腺腺癌的诊断准确率,对前列腺穿刺标本进行不同病变的鉴别诊断更有帮助.     

p504S、p63抗体混合离心法在前列腺癌诊断中的应用

 目的　应用在前列腺组织中新型肿瘤标志物p504S蛋白和基底细胞标志物p63的表达，以一次性标记来同步显示双重抗原，以辅助提高前列腺癌诊断的准确率。方法　从837例前列腺标本中，选取前列腺癌标本72例，前列腺上皮内瘤（PIN）标本6例，良性增生标本30例，把抗体混合离心法应用于免疫组织化学标记中，观察p504S、p63在前列腺良性增生、PIN和前列腺癌中的表达。结果　在确诊的72例前列腺癌患者中，p504S阳性61例， p63除1例呈间断阳性外其余71例均阴性。6例PIN中，p504S阳性5例，p63均为阳性。而30例良性增生则表现为p504S 29例阴性，p63 27例阳性。结论　p504S和p63抗体混合离心法双标记的应用，将极大地提高前列腺癌的诊断准确率。     

P504S、P63、3413E12、PSA联合应用在前列腺疾病诊断中的价值

目的：通过对前列腺标本进行免疫组织化学联合标记P504S、P63、3413E12、PSA检测,探讨以上标记物在前列腺疾病组织中的表达及意义,为正确诊断前列腺疾病提供依据。方法：选取重庆市垫江县人民医院病理科2007年1月-2011年8月所有前列腺标本448例,另有颅内转移性前列腺癌手术切除标本l例,共计449例。在448例前列腺标本中,手术切除58例,汽化电切382例,穿刺活检8例（其中1例为颅内转移性肿瘤确诊后前列腺穿刺标本）。全部标本均进行P504S、P63、3413E12、PSA免疫组织化学染色标记。结果：P504S在32例前列腺腺癌中有28例呈阳性表达,3例呈灶性阳性,1例阴性;在部分不典型腺瘤样增生、低级别PIN、高级别PIN中呈灶性阳性表达。P63、3413E12标记显示前列腺腺癌中基底细胞缺失,在部分高级别PIN中也存在基底细胞不连续现象。而PSA在所有前列腺标本中除恶性淋巴瘤未表达外,其余均明显阳性表达,其在转移性肿瘤中的表达也非常明确。结论：联合应用多抗体检测在前列腺疾病诊断中大大地提高了前列腺疾病诊断的准确性,为前列腺疾病的早发现、早治疗提供了有力的依据。     

P504S/AMACR在穿刺前列腺癌标本中的表达及其临床意义

目的:研究P504S/AMACR在穿刺前列腺癌标本中的表达及其临床意义。方法:应用免疫组化二步法检测穿刺前列腺癌标本中P504S/AMACR的表达情况,并分析其在肿瘤组织中的表达与各临床病理因素的相关性。结果:P504S/AMACR在前列腺高级别上皮内瘤变（HGPIN）和前列腺癌组织中的表达显著高于癌旁前列腺组织,P504S/AMACR的高表达与患者高 Gleason 评分（P<0.01）及骨转移之间（P<0.01）存在显著相关性。但其表达与患者年龄、术前总PSA、临床分期之间均无显著相关性（P>0.05）。结论:P504S/AMACR在不同前列腺组织中的表达强度不同,其表达强度与前列腺癌Gleason评分和骨转移明显相关。     

Specificity of serum prostate-specific antigen determination in the Finnish prostate cancer screening trial

Specificity constitutes a component of validity for a screening test. The number of false-positive (FP) results has been regarded as one of major shortcomings in prostate cancer screening. We estimated the specificity of serum prostate-specific antigen (PSA) determination in prostate cancer screening using data from a randomised, controlled screening trial conducted in Finland with 32 000 men in the screening arm. We calculated the specificity as the proportion of men with negative findings (screen negatives, SN) relative to those with negative and FP results (SN/(SN+FP)). A SN finding was defined as either PSA相似文献   

Post-therapy serum prostate-specific antigen level and survival in patients with androgen-independent prostate cancer

BACKGROUND: With an hypothesis that post-chemotherapy changes in serum prostate-specific antigen (PSA) levels might serve as a surrogate marker for assessing prostate cancer outcome (i.e., survival), we studied the relationship between pretherapy and post-therapy prognostic factors and survival in patients with androgen-independent prostate cancer. METHODS: A prognostic model for survival based on pretherapy and post-therapy parameters was developed from the clinical data on 254 patients with androgen-independent prostate cancer treated with 11 different protocol therapies at Memorial Sloan-Kettering Cancer Center. The model was validated by use of an independent dataset of 541 patients enrolled in two randomized phase III trials. RESULTS: In multivariate analysis, a post-therapy decline in PSA levels of 50% achieved in 12 weeks was a statistically significant factor associated with survival (two-sided P = .0012). A similar outcome was obtained with the use of an 8-week time frame. Elevated pretherapy level of serum lactate dehydrogenase (two-sided P = .0001), lower pretherapy level of hemoglobin (P = .0001), and younger age (two-sided P = .0430) had a statistically significant negative impact on outcome. Median survival times were 23, 17, and 9 months for low-, intermediate-, and high-risk groups of patients defined by the prognostic model, respectively. CONCLUSION: This study confirms the prognostic value of a post-therapy decline in PSA of 50% or greater from baseline in relation to survival in patients with androgen-independent prostate cancer treated with a variety of therapies. Two consecutive determinations at 4-week intervals can be used as an end point for efficacy in phase II trials of therapies in this disease.     

Detection of prostate cancer using prostate-specific antigen adjusted for the transition zone volume in patients with intermediate serum prostate-specific antigen levels

Background. The prostate-specific antigen (PSA) density of the transition zone (PSATZ) in patients with PSA values of 4.1–10 ng/ml was determined to find whether PSATZ is useful in the detection of prostate cancer. Methods. The PSA, PSA density (PSAD), and PSATZ were determined in 101 patients with intermediate levels of serum PSA. The relationship of these parameters to prostate cancer detection was examined. Results. Patients with prostate cancer had significantly higher PSAD and PSATZ values than those without prostate cancer. In patients with a PSA value of 4.1–10 ng/ml, especially in those without abnormal digital rectal examination findings, PSATZ was superior to PSA as an indicator for positive biopsy when analyzed by receiver operating characteristics curves. In those patients with a cutoff value of 0.3 ng/ml per ml of transition zone volume, PSATZ had a sensitivity of 79% and a specificity of 51%. A cutoff value of 0.3 for PSATZ provided a sensitivity of 88% and a specificity of 51% in patients without abnormal digital rectal examination findings. Conclusion. The present study demonstrated that PSATZ was superior to PSA as an indicator for positive biopsy, especially in patients with normal digital rectal examination findings. PSATZ was not superior to PSAD in the detection of prostate cancer. Received: November 17, 1999 / Accepted: April 11, 2000     

p300 regulates androgen receptor-independent expression of prostate-specific antigen in prostate cancer cells treated chronically with interleukin-6

Prostate cancer is the most frequent non-skin cancer in men. Although the mechanisms involved in the progression of prostate cancer are not entirely understood, androgen receptor has been shown to play an important role. Androgen receptor is expressed in both early and late-stage prostate cancer. Also, androgen-regulated pathways are thought to be active as evidenced by elevated levels of prostate-specific antigen (PSA). In addition, several androgen receptor coactivators and cytokines are involved in prostate cancer progression. In this regard, we have shown previously that the coactivator p300 plays a major role in the androgen-independent activation of PSA by interleukin 6 (IL-6), a cytokine involved in late-stage prostate cancer. In this study, we investigated the role of p300 and its homologue CREB-binding protein in prostate cancer cells treated chronically with IL-6. We found that p300 but not CREB-binding protein induced activation of PSA in these cells and that the histone acetyltransferase activity of p300 was critical. This effect was independent of the presence of androgens or antiandrogens. Moreover, we found markedly reduced levels of androgen receptor in these cells and p300 transfection did not affect those levels, suggesting that the p300 effect on PSA could be bypassing the androgen receptor. Transfection with exogenous androgen receptor showed minimal response of PSA to androgens but higher response to p300. We found similar effects of p300 on the androgen response element III, which mediates the androgen receptor-dependent activation of PSA. Finally, we showed that p300 alone regulates expression of the endogenous PSA gene in the IL-6-treated cells. These findings reveal a new insight in the progression of prostate cancer, suggesting that coactivators, such as p300, play more important roles in late-stage prostate cancer, and could regulate androgen-dependent genes in the absence or with very low levels of androgen receptor.     

Racial differences in prostate-specific antigen levels and prostate-specific antigen densities in patients with prostate cancer

To compare serum prostate-specific antigen (PSA) levels and PSA density (PSAD) among African American (AA), white, and Hispanic men with prostate cancer (PC) seen in an urban, equal-access urology clinic. Between January 1988 and January 1993, 1,105 men were screened for PC at Cook County Hospital in Chicago, Illinois. A total of 529 men underwent transrectal ultrasound-guided prostate gland biopsies for abnormal digital rectal examination, suspect transrectal ultrasound, elevated PSA, or any combination of these abnormalities. PC was found in 246 patients (204 AAs, 22 whites, and 20 Hispanics). We analyzed the differences in PSA and PSAD among the three racial groups using univariate and multivariate analyses adjusting for race, age, clinical stage, and grade. AAs have a higher mean serum PSA levels (21.56 ng/ml) than whites (mean PSA of 10.96 ng/ml) and Hispanics (mean PSA of 8.25 ng/ml) (p = 0.04). The mean PSAD also was higher in AAs than in the other two groups (0.68 versus 0.34 for whites and 0.31 for Hispanics, p = 0.05). On a multivariate analysis, the PC stage and grade were overwhelmingly significant, whereas the race and age lost their statistical significance. AAs have higher serum PSA and PSAD than whites or Hispanics in an equal-access healthcare environment. Race is a significant factor in determining PSA and PSAD on univariate but not on multivariate analysis. Preliminary studies suggest that these differences are due to sociological, not biologic causes. These findings warrant a large, prospective study to investigate the extent and the causes of the racial differences in PSA and PSAD.     

Transrectal ultrasound in detecting prostate cancer compared with serum total prostate-specific antigen levels

We carried out a retrospective study to review the efficiency of grey-scale transrectal ultrasonography (TRUS) in detecting prostate cancer compared with the data in recent published work, including alternative imaging methods of the prostate gland. Our study group consisted of 830 patients who underwent TRUS-guided biopsy of the prostate between May 2000 and June 2004. The relation between abnormal TRUS findings and serum total prostate-specific antigen (tPSA) levels was evaluated in patients with prostate cancer who were divided into three different groups according to serum tPSA levels. Group I included patients with tPSA levels of 4-9.9 ng/mL, group II included tPSA levels of 10-19.9 ng/mL and group III included patients with tPSA levels of 20 ng/mL or more. In general, TRUS detected 185 (64%) of 291 cancers with a specificity of 89%, a PPV of 76% and an accuracy of 80%. TRUS findings enabled the correct identification of 22 (56%) of the 39 cancers in group I, 28 (30%) of the 93 cancers in group II and 135 (85%) of the 159 cancers in group III. In conclusion, TRUS alone has a limited potential to identify prostate cancer, especially in patients with tPSA levels lower than 20 ng/mL. Therefore, increased numbers of systematically placed biopsy cores must be taken or alternative imaging methods are required to direct TRUS-guided biopsy for improving prostate cancer detection.