超声引导下前列腺穿刺病理标本免疫学指标与前列腺癌相关性  

Relationship between prostate cancer and immunological parameters in ultrasound-guided prostate biopsy specimens

作　　者：赖己创 曾宝辉 陈佳琳[1] 郭顺华[1] 过新民[1] LAI Jichuang;ZENG Baohui;CHEN Jialin;GUO Shunhua;GUO Xinmin(Department of Ultrasound Diagnosis,Guangzhou Red Cross Hospital,Medical College,Jinan University,Guangzhou 510220,China)

机构地区：[1]暨南大学医学院附属广州红十字会医院超声诊断科,广州510220

出　　处：《实用医学杂志》2019年第6期898-902,共5页The Journal of Practical Medicine

基　　金：广东省科技计划项目(编号:2016A020215015)

摘　　要：目的探讨α-甲酰基辅酶A-消旋酶(P504s)、高分子量角蛋白(CK-h)、p63蛋白、S-100蛋白等免疫指标与前列腺癌的相关性及临床诊断价值。方法回顾分析我院2012年7月至2016年8月疑诊前列腺癌患者238例,均行超声引导下前列腺穿刺活检,免疫组化检测P504s、CK-h、p63、S-100的表达,分数据库相关数据分析p63及S-100表达与前列腺癌患者预后的关系。结果 238个病例中,穿刺病理结果前列腺癌82例,P504s在前列腺癌病例中的阳性表达率明显高于在非癌病例(96.34%vs. 12.18%),p63和CK-h在非癌病例中的阳性表达率明显高于前列腺癌病例(100%vs. 3.66%),差异均有统计学意义(P <0.05)。P504s作为前列腺癌的标记物,敏感度为96.34%,特异度为87.92%,p63及CK-h在非前列腺癌病例中均呈阳性表达。p63高表达是前列腺癌术后无生化复发生存的保护性因素,S-100高表达是前列腺癌术后无病生存的保护性因素。结论 P504s作为前列腺癌标记物敏感度与特异度均较高,p63和CK-h可应用于前列腺癌与非癌的鉴别诊断,p63、S-100均可作为前列腺癌的独立预后指标。结合分析上述指标有助于提高超声引导下前列腺癌穿刺活检的阳性符合率。Objective To investigate the correlation of P504s,CK-h,p63 and S 100 with prostate cancer and their clinical diagnostic value. Methods Data of 238 patients with suspected prostate cancer in our hospital from July 2012 to August 2016 were retrospectively analyzed.All patients underwent ultrasound- guided prostate biopsy. The expressions of P504s,CK-h,p63 and S-100 were detected and their correlation with the diagnosis of prostate cancer was analyzed. Meanwhile, the relationship between p63 and S-100 expression and prognosis of prostate cancer was analyzed based on TCGA database. Results Of the total,82 cases of prostate cancer were found by biopsy. The positive expression rate of P504s in prostate cancer patients was significantly higher than that in non cancer patients (96.34% vs. 12.18%). The positive expression rates of p63 and CK h in non cancer patients were significantly higher than those in prostate cancer cases( 100% vs. 3.66%). As a marker of prostate cancer,P504s showed a sensitivity of 96.34% and specificity of 87.92%. Both p63 and CK h were positive in non prostate cancer patients. The high expression of p63 was a protective factor for the survival without biochemical recurrence after prostate cancer surgery, and the high expression of S-100 was a protective factor for the disease free survival after prostate cancer surgery. Conclusion P504s can be used as a marker with high sensitivity and specificity for prostate cancer;P63 and CK h can be applied to the differential diagnosis of prostate cancer and P63 and S-100 can be used as independent prognos tic indicators for prostate cancer,which all help to improve the positive rate of ultrasound guided prostate biopsy.

关 键 词：前列腺癌 穿刺活检 免疫组化 α-甲酰基辅酶A-消旋酶 高分子量角蛋白 P63蛋白 S-100蛋白 

分 类 号：R737.25[医药卫生—肿瘤]