AMACR(P504S)、P63、34βE12联合检测在前列腺癌早期诊断中的应用

目的:探讨AMACR(P504S)、P63、34βE12联合检测在前列腺癌(PCa)早期诊断中的临床应用价值。方法:应用即用型组合式单克隆抗体和双酶标记的免疫组化MaxvisionTM一步法检测42例PCa、12例高级别前列腺上皮内瘤变(HGPIN)和30例良性前列腺增生(BPH)穿刺活检标本中AMACR、P63、34βE12的表达情况。比较Glea-son评分各组中AMACR阳性表达情况。结果:AMACR、P63、34βE12抗原在PCa和BPH穿刺标本中的表达差异均有极显著性(P<0.01),PCa组织中AMACR阳性表达率为100%,无P63和34βE12表达;BPH组织中均无AM-ACR表达,P63和34βE12均高表达。HGPIN中AMACR的阳性表达率(91.67%)与BPH差异有极显著性(P<0.01),与PCa差异无显著性(P>0.05);P63和34βE12阳性表达率HGPIN(100%)与PCa差异有极显著性(P<0.01),而与BPH差异无显著性(P>0.05)。AMACR表达强弱与PCa的Gleason评分无关(P>0.05)。结论:AMACR是PCa高度敏感和特异的标志物,P63和34βE12联合标记基底细胞的特异性高,3者联合检测能增加前列腺穿刺活检标本诊断的准确性,在PCa早期诊断中具有重要的临床应用价值。

Detection of AMACR (P504S), P63 and 34βE12 Cocktail in the Early Diagnosis of Prostate Cancer

OBJECTIVE: To investigate the value of detection of AMACR (P504S), P63 and 34betaE12 cocktail in the early diagnosis of prostate cancer (PCa). METHODS: The expressions of AMACR, P63 and 34betaE12 were examined in the biopsy specimens of 42 cases of prostate cancer, 12 cases of high-grade prostatic intraepithelial neoplasia (HGPIN) and 30 cases of benign prostatic hyperplasia (BPH) using the Maxvision single-step immunohistochemical method with triple-antibody cocktail (AMACR/P63/34betaE12) staining and double-color chromogens in single paraffin sections . RESULTS: The expressions of AMACR, P63 and 34betaE12 were significantly different between PCa and BPH (P < 0.01). The staining of PCa was positive for AMACR and negative for P63 and 34betaE12, and the positivity rate of AMACR was 100%. BPH was strongly expressed for P63 and 34betaE12, but negatively for AMACR. The expression of AMACR was significantly different between HGPIN and BPH (P < 0.01), but not between HGPIN and PCa (P > 0.05), and the positivity rate of AMACR in HGPIN was 91.67%. However, the expressions of P63 and 34betaE12 were significantly different between HGPIN and PCa (P < 0.01), but not between HGPIN and BPH (P > 0.05), and the positivity rate of AMACR in HGPIN was 100%. The level of AMACR expression was not correlated with PCa Gleason score (P > 0.05). CONCLUSION: AMACR is a sensitive and specific marker for PCa. P63 and 34betaE12 cocktail staining can increase the sensitivity and specificity of the basal cell detection. The immunohistochemical analysis with triple-antibody cocktail (AMACR/P63/34betaE12) staining and double-color chromogens can improve diagnostic accuracy and has an important applied value for the early diagnosis of prostate cancer.