穿刺活检前列腺癌ERG基因重排分析  

ERG rearrangement prevalence in Chinese prostatic carcinoma biopsy cohort

作　　者：肖立[1] 殷于磊[1] 陈燕[1] 卢晨[1] 余波[1] 

机构地区：[1]复旦大学附属华东医院病理科,上海200040

出　　处：《临床与实验病理学杂志》2015年第10期1110-1114,共5页Chinese Journal of Clinical and Experimental Pathology

基　　金：上海市卫计委科研课题(H-754)

摘　　要：目的：探讨ERG基因重排在前列腺癌中的发生率及特征。方法收集前列腺癌连续穿刺标本242例,均为6～14针,左、右侧不同部位分瓶送检,年龄58～91岁,PSA水平5～5000 ng/ml,免疫组化法检测ERG蛋白表达,荧光原位杂交（ fluores-cent in situ hybridization, FISH）技术检测ERG基因重排。结果免疫组化法检测42例前列腺癌中ERG蛋白阳性,阳性率为17．4%,阳性病例FISH检测均见基因重排现象,其中19例为缺失型信号,23例为分离型信号；阴性者均未见基因重排现象。5例同时存在ERG阳性与阴性腺癌病灶。周围良性腺体未见ERG蛋白表达和基因重排现象。阳性病例中,Gleason评分6者12例,Gleason评分7者23例,Gleason评分8或以上者7例。 PSA水平〈100 ng/ml组ERG阳性率为19．6%,PSA水平〉100 ng/ml组ERG阳性率为10%。肿瘤临床分期T3或以内组ERG阳性率为17．2%,T4组及有盆腔淋巴结转移或有远处转移组阳性率为19%。χ2检验显示ERG基因重排与低Gleason评分腺癌相关,与PSA水平、临床分期、疾病进展无相关性。结论免疫组化是检测ERG基因重排、前列腺癌诊断的重要辅助指标。前列腺癌多灶现象常见。 ERG基因重排与临床预后无明显相关性。Purpose To study the prevalence and feature of EGR gene rearrangement in prostatic carcinoma. Methods 242 consecu-tive core biopsies of prostatic carcinoma were evaluated. All biopsy specimens contained 6-14 cores from left and right sides separately delivered. The patient age ranged 58 to 91 years, and PSA value 5 ng/ml to more than 5 000 ng/ml. Immunohistochemistry （ IHC） for ERG protein overexpression and fluorescent in situ hybridization （ FISH） for ERG gene rearrangement were performed. Results 42 cases were detected positive for ERG by IHC （ positive rate 17. 4%） , and positive for ERG rearrangement by FISH either, with 19 ca-ses showing fusion through deletion and 23 through insertion, while no negative cases by IHC demonstrated positive by FISH. 5 cases revealed positive and negative staining in different carcinoma foci of ERG. No ERG positive staining and rearrangement were found in adjacent benign glands. Of positive cases, 12 cases were graded as Gleason score 6, 23 Gleason score 7, and 7 Gleason score 8 or more. Positive rate was 19. 6% in the group of PSA value less than 100 ng/ml, and 10% of more than 100 ng/ml, whereas 17. 2% in the group of clinical T3 stage or less, and 19% of clinical T4 and lymph node or remote metastasis. ERG rearrangement was associated with lower Gleason score, but not with PSA value, clinical stage and progression using theχ2 test analysis. Conclusions IHC is relia-ble for detection ERG rearrangement and helpful for interpretation of prostatic carcinoma. Multiple foci are common in prostatic carcino-ma. There is no significance between ERG rearrangement and disease prognosis.

关 键 词：前列腺肿瘤 ERG基因 免疫组织化学 荧光原位杂交 预后 

分 类 号：R737.25[医药卫生—肿瘤]