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。     

前列腺癌组织BSP和PSA的表达及意义

[目的]探讨骨唾液酸蛋白（BSP）与前列腺特异性抗原（PSA）在前列腺癌组织中的表达及意义。[方法]选取不同病理分级的前列腺癌组织（68例）和前列腺增生组织（22例）,采用免疫组织化学SP法染色,检测BSP及PSA的表达情况。[结果]BSP在前列腺癌中阳性率为76.47%,显著高于前列腺增生组织（13.64%）（χ^2=27.614,P〈0.001）。BSP在不同分化程度前列腺癌组织中表达差异无统计学意义（χ^2=0.057,P=0.972）。前列腺增生组织、前列腺癌组织的PSA表达率分别为90.91%、69.12%,差异有统计学意义（χ^2=4.149,P=0.042）。不同分化程度前列腺癌PSA表达差异有统计学意义（χ^2=11.437,P=0.003）。BSP与PSA表达具有显著相关性（rs=0.654,P〈0.001）。[结论]BSP在前列腺癌中高表达,与PSA表达相关。BSP可能在前列腺癌的发生、发展中起重要作用,可能成为前列腺癌治疗的新靶点。     

前列腺穿刺患者前列腺癌检出率及其与 PSA、年龄的相关性

目的：探讨前列腺穿刺患者前列腺癌检出率情况,并分析其与前列腺特异性抗原（prostate specific an-tigen,PSA）、年龄的相关性。方法：回顾性收集2009年1月至2015年12月自贡市第一人民医院收治的年龄≥50岁且符合前列腺穿刺活检指征患者232例,对患者行 PSA 检测、直肠指诊（digital rectal examination,DRE）和经腹前列腺超声、MRI 检查,计算前列腺癌的检出率,分析前列腺癌检出率与年龄、PSA 水平的相关关系。结果：本组232例穿刺活检患者中,病理诊断为前列腺癌74例,阳性检出率为31．9％（74／232）。74例患者中,高分化癌16例（21.6％）、中分化癌24例（32．4％）、低分化癌34例（45．9％）。PSA 值＜4μg／L、4．1～10μg／L、10．1～20μg／L、＞20μg／L 4组患者前列腺癌检出率分别为9．1％、13．0％、16．2％、52．3％,随着 PSA 值的增加,前列腺癌检出率增长明显,呈明显的上升趋势（P ＜0．001）。随着年龄增高,PSA 值也越大,差异有统计学意义（Z ＝－3．328,P ＜0.001）;年龄＜60岁、60～69岁、70～79岁、≥80岁4个年龄组前列腺癌的检出率分别为11．1％、23．6％、40．0％、46.7％,随着年龄的增长,前列腺癌的检出率增长明显（P ＝0．011）。前列腺穿刺患者前列腺癌检出率与血清 PSA值呈正相关（r ＝0．376,P ＜0．001）,前列腺癌检出率与年龄亦呈正相关（r ＝0．288,P ＝0．019）。结论：随着年龄的增加、血清 PSA 值增高,前列腺穿刺患者前列腺癌的检出率也相应增高。     

血清hK2、AMACR联合PSA检测对前列腺癌诊断及预后判断的临床价值

目的:探讨血清腺激肽释放酶2（hK2）、甲基酰基辅酶A消旋酶（AMACR）联合前列腺特异性抗原（PSA）检测对前列腺癌诊断及预后判断的临床价值。方法:前瞻性选取2016年01月至2018年01月收治的前列腺癌患者50例为前列腺癌组和良性前列腺增生患者50例为良性前列腺增生组。并以同期健康查体者50例为对照组。检测比较三组血清hK2、AMACR和PSA水平,Logistic分析血清hK2、AMACR和PSA水平对前列腺癌发生状况的影响,ROC曲线分析血清hK2、AMACR和PSA水平联合检测对前列腺癌的诊断效能。对前列腺癌组进行为期3年的随访,记录患者复发和生存情况。比较不同复发和生存预后情况患者的基线血清hK2、AMACR和PSA水平,Logistic分析基线血清hK2、AMACR和PSA水平对前列腺癌患者复发和生存预后的影响,ROC曲线分析血清hK2、AMACR和PSA水平联合检测对前列腺癌患者复发和死亡早期评估效能。结果:前列腺癌组血清hK2、AMACR水平高于良性前列腺增生组和对照组（P＜0.05）;而良性前列腺增生组和对照组血清hK2、AMACR水平比较差异无统计学意义（P＞0.05）。前列腺癌组、良性前列腺增生组和对照组的血清PSA水平依次降低（P＜0.05）。Logistic分析结果显示,血清hK2、AMACR和PSA水平对前列腺癌发生状况具有明显影响（P＜0.05）。ROC曲线分析结果显示血清hK2、AMACR和PSA水平联合检测对前列腺癌具有良好的诊断效能。前列腺癌组50例患者的3年复发率和生存率分别为56%（28/50）和52%（26/50）。前列腺癌组复发患者的血清hK2、AMACR和PSA水平均高于未复发患者（P＜0.05）;且前列腺癌组死亡患者的血清hK2、AMACR和PSA水平均高于存活患者（P＜0.05）。Logistic分析结果显示,血清hK2、AMACR和PSA水平均受到前列腺癌患者复发和生存预后的影响（P＜0.05）。ROC曲线分析结果显示血清hK2、AMACR和PSA水平联合检测对前列腺癌患者复发和死亡均具有良好的早期评估效能。结论:血清hK2、AMACR和PSA水平在前列腺癌患者中表达水平较高,具有一定的前列腺癌诊断价值,且可能作为预后早期预测的有效参考指标。     

前列腺癌肿瘤相关抗原表达的意义

应用ＰＳＡ，ＰＳＡ，ＰＡＰＡ和ＣＥＡ对２５例前列腺癌进行免疫组织化学检测，同时检测正常前列腺４例，增生前列腺８例。结果表明，ＰＳＡ和ＰＡＰ为 前列腺皮皮标记，ＰＳＡ更敏感。ＰＳＡ表达与前列腺癌的分化程度相关，ＰＡＰ却无相关。ＣＥＡ多在分化好的前列腺癌中表达。     

TRIM29联合PSA在前列腺癌诊断中的应用

目的:探讨TRIM29在前列腺癌的表达情况,并讨论其异常表达与前列腺癌Gleason评分、骨转移等临床病理特征间的关系以及TRIM29联合前列腺癌特异性抗原(prostate specific antigen,PSA)检测在前列腺癌诊断中的应用前景。方法:56例经病理确诊的前列腺癌患者为实验组,25例良性前列腺增生(benign prostatic hyperplasia,BPH)患者为对照组。应用免疫组化和Western blot法检测TRIM29蛋白表达水平,检测患者外周血PSA水平。二元回归法分析PSA、TRIM29相关诊断性能。结果:正常前列腺基底细胞均可见TRIM29表达,而前列腺癌组织则呈低表达,Western blot结果提示前列腺组织中TRIM29表达水平明显低于正常前列腺组织(P<0.01),在前列腺伴发骨转移患者中TRIM29表达水平低于不伴骨转移患者(P=0.038),TRIM29表达水平与前列腺患者Gleason评分密切相关,TRIM29表达与PSA无相关性,其诊断效价略优于PSA(P=0.041)。结论:TRIM29低表达与前列腺癌发生关系密切,可作为前列腺诊断的潜在靶点,辅助PSA达到早期诊断前列腺的目的。     

前列腺癌组织中Kindlin-2和Clusterin蛋白表达及与PSA含量的相关性

目的:探讨前列腺特异性抗原（PSA）含量和前列腺癌（PCA）组织中Clusterin、Kindlin-2蛋白阳性表达的相关性,研究前列腺癌的治疗策略。方法:45例前列腺增生和55例前列腺癌组织应用免疫组织化学方法检测凋亡蛋白Kindlin-2、Clusterin的表达并检测对应病例的血浆PSA含量。结果:Clusterin、Kindlin-2蛋白在前列腺癌组织中的阳性表达率分别为50.9%(28/55)、63.6%(35/55),Clusterin和Kindlin-2蛋白在前列腺增生组织中的阳性表达率分别为0(0/45)、51.1%(23/45)。在前列腺癌和前列腺增生组织中Clusterin和Kindlin-2阳性表达率具有统计学差异(P<0.05);Clusterin和Kindlin-2蛋白表达与前列腺癌病理分级、临床分期、转移情况和PSA含量相关,差异有统计学意义（P<0.05）。结论:联合检测Kindlin-2、Clusterin蛋白和PSA可为前列腺癌提供一种新的联合检查方法。     

前列腺癌术后 Gleason 分级与 PSA、P504s、Ki -67蛋白表达相关性分析

目的：探讨前列腺癌 Gleason 分级评分与 PSA、P504s、Ki -67蛋白免疫组化表达的关系。方法：采用免疫组化 SP 法检测45例前列腺癌患者术后石蜡包埋组织中 PSA、P504s、Ki -67的表达，并根据 HE 切片进行 Gleason 分级评分。结果：前列腺癌 Gleason 分值越高，PSA 阳性表达越弱（P ﹤0.05），Ki -67阳性表达越强（P ﹤0.05）；P504s 强表达，与 Gleason 评分无相关性（P ﹥0.05）。结论：PSA 表达越弱、Ki -67表达越强，前列腺癌组织分化程度越差，预后越差。P504s 在前列腺癌中强表达，可应用于诊断，与预后无明显相关性。     

前列腺癌P504S、p63及CK34βE12表达的研究

目的：探讨P504S、p63及CK34βE12表达在前列腺癌诊断和鉴别诊断中的价值。方法：采用免疫组织化学技术，检测P504S、p63及CK34βE12在各类前列腺病变中的表达。结果：102例前列腺癌中有92例表达P504S（90．2％）；P504S在良性前列腺病变上皮中表达率是8．2％（8／97），在前列腺高级别上皮内瘤（high grade intraepithelial neoplasias，HGPIN）中表达率是39．5％（15／38）。在切除的前列腺良性标本中，有〉2个腺体的p63表达缺失例数发生率为28．8％，明显低于CK34βE12的发生率53．0％（P〈0．05）。结论：P504S是前列腺癌敏感的生物学标志物；p63在前列腺基底细胞表达完整性方面优于CK34βE12；P504S和基底细胞标志物在临床病理诊断中联合应用可达到互补的作用。     

前列腺特异性膜抗原和前列腺特异性抗原表达强度与前列腺癌Gleason评分之间的相关性研究

目的研究前列腺特异性膜抗原(PSMA)和前列腺特异性抗原(PSA)的表达强度与前列腺癌Gleason评分之间的相关性。方法制备抗PSMA膜外段表位的单克隆抗体,应用免疫组织化学方法检测前列腺癌中PSMA的表达,统计分析其与Gleason评分之间的相关性,并和PSA与Gleason评分之间的相关性进行对比。结果制备出8株分泌抗PSMA膜外段表位的单抗的杂交瘤细胞株。免疫组化结果表明,PSMA的表达强度与前列腺癌的Gleason评分之间存在相关性。在分化差的前列腺癌中,PSMA水平高于分化中等和分化良好的前列腺癌(P<0.01),而PSA在前列腺癌中的表达无明显差异(P>0.05)。结论PSMA表达水平在分化差的前列腺癌中明显升高,与Gleason评分存在相关性,可以作为前列腺癌的Gleason分级的标记物,提示PSMA可以作为对激素疗法效果不敏感的低分化前列腺癌抗体介导的免疫治疗靶点。     

Evaluation of two serum isoenzyme phosphatases as bone metastasis markers

Serum activities of bone alkaline phosphatase (b-ALP) and of tartrate resistant acid phosphatase (tr-ACP) were evaluated in 271 cancer patients; 120 of them had bone metastases (BM) and 151 had none. Correlation coefficients, specificities, sensitivities, negative and positive predicting values were computed. They showed the important contribution that these isoenzymes can bring to the diagnosis of BM in 80 patients with prostate cancer, and to the followup of 191 patients with breast cancer. The assay results were analysed in parallel with bone scan and radiography. They were also compared to those of serum antigens: PSA and PAP for prostate cancer, and CEA and CA15.3 for breast cancer. These results clearly indicate that both isoenzymes are better correlated with BM than antigens, these antigens being markers of the whole tumor burden--primary tumor, metastases, recurrence--whereas b-ALP and tr-ACP are specific markers of bone metabolism.     

Nipple fluid carcinoembryonic antigen and prostate-specific antigen in cancer-bearing and tumor-free breasts.

PURPOSE: Mammograms and breast examinations are established methods for early breast cancer detection. Routine mammography screening reduces breast cancer mortality among women ages > or = 50 years, but additional screening methods are needed. We and others have found high levels of carcinoembryonic antigen (CEA) and prostate-specific antigen (PSA) in nipple aspirate fluids (NAFs), but the usefulness for these bio-markers for early breast cancer detection is unknown. PATIENTS AND METHODS: NAFs from one or both breasts of 388 women were analyzed for CEA, PSA, and albumin levels. The study included 44 women with newly diagnosed invasive breast cancers, 67 women with proliferative breast lesions (ductal and lobular carcinoma in situ and atypical ductal hyperplasia), and 277 controls without these breast lesions. Analyses were conducted using the log(10)-transformed CEA and PSA levels to normalize the distributions of these tumor markers. RESULTS: Nipple fluid CEAs are significantly higher for cancerous breasts than tumor-free breasts (median 1,830 and 1,400 ng/mL, respectively; P <.01). However, at 90% specificity of the assay (CEA = 11,750 ng/mL), the corresponding sensitivity for cancer detection is 32%. CEA levels are not significantly different for breasts with proliferative lesions compared with tumor-free breasts. Nipple fluid PSAs do not differ by tumor status. Analyses of NAF albumin-standardized CEAs and PSAs yield similar results. Nipple fluid CEA and PSA titers are correlated in the affected and unaffected breast of women with unilateral lesions. CONCLUSION: Nipple fluid CEAs are higher for breasts with untreated invasive cancers, but the test sensitivity is low. Nipple fluid PSA titers do not seem to be useful for breast cancer detection.     

Tissue CEA as a prognostic factor in advanced and recurrent breast cancers

We stained tissue CEA in specimens of 25 advanced and reccurrenced breast cancers using the PAP method. We concluded the following: Tissue CEA positivity was 56.0% (14 out of 25 cases). Tissue CEA positivity was not correlated with age, clinical stage or histological type of primary breast cancer. Tissue CEA-positive breast cancers tended to have multiple distant metastases and very poor prognoses as opposed to negative ones.     

Estrogen staining in breast carcinoma by PAP methods compared to CEA and ferritin staining

The aims of this paper are to demonstrate the stainability of estrogen, CEA, and ferritin in breast carcinomas, fibroadenomas, and fibrocystic diseases; to examine whether the findings of endogenous estrogen using the immunohistochemical detection method are related to estrogen receptor (ER) assays; and to determine whether the stainability of estrogen, CEA, and ferritin were related to the prognosis of breast carcinomas. In breast cancer, the stainability of estrogen using the peroxidase-antiperoxidase (PAP) method was positively correlated with the dextran-coated charcoal (DCC) assay for ER. In breast cancers, the percentage of positive staining was 46% for estrogen, 48% for CEA, and 47% for ferritin. With all three stains, significant differences were observed between cancer and benign diseases. Cases that were both positive for estrogen staining and negative for CEA showed a good prognosis after the recurrence of disease. Our data suggest that the immunohistochemical staining of estrogen, CEA, and ferritin might predict the biological behavior of breast carcinomas and be a prognostically useful indicator of breast cancer patients.     

Clinical usefulness of prostate-specific antigen and prostatic acid phosphatase in patients with prostatic cancer.

Serum prostate-specific antigen (PSA) and prostatic acid phosphatase (PAP) levels were measured in 70 patients with benign prostatic hypertrophy (BPH) and in 70 patients with prostatic cancer. PSA was increased above the cutoff level of 10 ng/ml in 13% of patients with BPH and in 87% of patients with prostatic cancer. In contrast, abnormal PAP levels were found in 14 and 76% of patients, respectively. We concluded that, due to its high specificity, PSA is a useful marker in the management of patients with prostatic carcinoma and that it surpasses PAP in this regard.     

Cross-comparison of PSA and PAP values in a wide spectrum of prostate cancer conditions

Serum PAP, PSA, and testosterone values were measured in 101 men with prostatic nodule. In 71 patients prostatic cancer was detected and in 62 of those patients monitoring studies of the same parameters were assessed on 153 sera by applying a radioimmunodetective procedure. The PSA test, when compared to PAP values, offers significantly greater sensitivity towards small tumor burdens in early stages of the disease, and enables, in some cases, the prediction of tumor recurrence before clinical symptoms have been manifested. The results of this study indicate that the addition of the PSA assessment to the standard protocol of prostate cancer diagnosis and treatment, either alone or together with PAP in a double-marker assay, is promising for more accurate staging and monitoring of patients with prostatic tumors.     

直肠癌组织VEGF-C与CEA及Survivin的表达与相关性研究

目的:探讨直肠癌组织中血管内皮细胞生长因子-C(VEGF-C)与CEA、Survivin表达的关系及其对直肠癌临床病理特征和预后的判定价值.方法:应用SP免疫组织化学方法检测VEGF-C、CEA和Survivin 3种蛋白在82例直肠癌组织及30例癌旁正常组织中的表达,分析它们与直肠癌病理学特征的关系,以及VEGF-C与CEA、Survivin的相关性.结果:直肠癌组织中VEGF-C与CEA、Survivin阳性表达率分别为45.1％、56.1％和47.6％.癌旁组织中Survivin蛋白表达率为5.0％,VEGF-C和CEA蛋白阳性表达率分别为10.5％和14.0％;直肠癌组织中VEGF-C表达与CEA表达呈正相关(r=0.287,P=0.024),与Survivin表达呈正相关,r=0.320,P=0.018.VEGF-C与CEA、Survivin的表达与TNM分期差异均有统计学意义(P＜0.05),与年龄、性别、肿块大小及病理分型差异均无统计学意义,P＞0.05.结论:VEGF-C与CEA、Survivin在直肠癌患者中高表达;其均与直肠癌的浸润、转移有关,三者联合检测可用于直肠癌的病期程度和预后判断的参考,可能对直肠癌的预后评估有一定的临床意义.     

An autopsy case of a gastric cancer associated with elevated AFP, CEA and CA19-9

A 48-year-old male developed gastric cancer (Borrmann III) with lung and liver metastases. Laboratory examination revealed a markedly elevated AFP (24, 241 ng/ml), CEA (9739.8 ng/ml), and CA-19-9 (726U/ml). Nevertheless, he underwent a subtotal gastrectomy for the hemostasis of a bleeding malignant lesion. Histological examination showed a moderately differentiated adenocarcinoma. A PAP for an AFP and a CEA disclosed positive staining. In addition, An autopsy revealed metastases to the liver and lungs with a positive result of PAP for AFP and CEA. Further, CA19-9 also was confirmed weakly in these same tissues, histochemically. Therefore this gastric cancer was considered an AFP, CEA, and CA19-9-producing tumor. Gastric cancer with 3 elevated tumor markers in the same patient is rare and its mechanism may elucidate the origin of gastric cancer and the resulting differentiation in the foregut.     

老年性肺癌患者CT影像学分型与血清肿瘤特异性标志物的相关性分析

目的:探讨分析老年性肺癌患者血清肿瘤特异性标志物与CT影像学分型的相关性。方法:选择我院收治的老年肺癌患者125例作为肺癌组,再选择肺部良性病变老年患者50例作为对照组,检测两组患者血清肿瘤特异性标志物糖链抗原199（CA199）、癌抗原125（CA125）、前列腺特异性抗原（PSA）、癌胚抗原（CEA）、神经元特异性烯醇化酶（NSE）水平,肺癌组患者进行CT影像学检查分型,分析不同CT影像学表现患者血清肿瘤特异性标志物水平变化。结果:肺癌组患者血清CA199、CA125、PSA、CEA、NSE水平均显著高于对照组（P<0.05）;有坏死空洞征象老年肺癌患者血清CA199、CA125、PSA、CEA、NSE水平均显著高于无坏死空洞征象老年肺癌患者（P<0.05）;有深分叶征象老年肺癌患者血清CA199、CA125、PSA、CEA、NSE水平均显著高于无深分叶征象老年肺癌患者（P<0.05）;有毛刺征象老年肺癌患者血清CA199、CA125、PSA、CEA、NSE水平均显著高于无毛刺征象老年肺癌患者（P<0.05）。结论:老年性肺癌患者CT影像学特征中有无坏死空洞征象、深分叶征象以及毛刺征象与患者血清肿瘤特异性标志物表达有关,联合使用CT影像学检查与血清肿瘤特异性标志物检查,更有利于疾病的准确诊断。