AMACR、p63及Ki-67三联免疫组化检测在前列腺癌病理诊断中的应用价值及临床意义  

Application value and clinical significance of AMACR, p63 and Ki-67 immunohistochemistry in pathological diagnosis of prostate cancer

作　　者：顾颖慧 施艳琳[1] 方新颜[1] Gu Yinghui;Shi Yanlin;Fang Xinyan(Department of Pathology,Qidong Hospital of Traditional Chinese Medicine,Qidong 226200,China)

机构地区：[1]启东市中医院病理科,启东226200

出　　处：《中国医师杂志》2025年第1期96-101,共6页Journal of Chinese Physician

基　　金：启东市医学科研项目(2021A020226)。

摘　　要：目的探讨α-甲酰基辅酶A消旋酶(AMACR)、p63及Ki-67三联免疫组化检测在前列腺癌病理诊断中的价值和意义。方法选择启东市中医院2022年6月—2023年8月收集的156块前列腺穿刺活检石蜡存档样本作为研究材料,采用免疫组织化学法检测48例前列腺癌、32例高级别前列腺上皮内瘤变、26例低级别前列腺上皮内瘤变和50例前列腺增生穿刺样本中的AMACR、p63和Ki-67表达情况。分析AMACR、p63和Ki-67表达与前列腺癌患者临床和病理特征间的相关性及其诊断前列腺癌的效能。结果不同组样本中AMACR、p63和Ki-67阳性表达率比较差异有统计学意义(均P<0.05),前列腺癌组穿刺样本中AMACR阳性表达率为100%,其中高表达率为81.25%,显著高于其他三组;p63阴性表达率为97.92%,显著高于其他三组;Ki-67阳性表达率为81.25%,高表达率为54.17%,显著高于其他三组。AMACR表达与前列腺癌患者肿瘤长径、TNM分期、分化程度和Gleason评分有关,肿瘤长径≥1.5 cm、Ⅱ~Ⅲ期、中高度分化、Gleason评分8~10分的患者AMACR高表达率分别显著高于肿瘤长径<1.5 cm、Ⅰ期、低分化、Gleason评分2~7分的患者(均P<0.05)。Ki-67表达与前列腺癌患者肿瘤长径、分化程度、淋巴结转移和Gleason评分有关,肿瘤长径≥1.5 cm、中高度分化、有淋巴结转移、Gleason评分8~10分的患者Ki-67高表达率分别显著高于肿瘤长径<1.5 cm、低分化、无淋巴结转移、Gleason评分2~7分的患者(均P<0.05)。p63表达与前列腺癌患者临床和病理特征无关(均P>0.05)。AMACR阳性/p63阴性/Ki-67阳性联合诊断前列腺癌的灵敏度和阴性预测值均为100.00%,特异度为81.82%。结论前列腺穿刺样本中AMACR、p63和Ki-67能够作为前列腺癌诊断或排除的良好生物标志物,联合检测能够提高前列腺癌诊断的准确性。Objective To investigate the value and significance ofα-methylacyl-CoA racemase(AMACR),p63 and Ki-67 immunohistochemical detection in the pathological diagnosis of prostate cancer.MethodsA total of 156 archived prostate biopsy paraffin samples collected from Qidong Hospital of Traditional Chinese Medicine from June 2022 to August 2023 were selected as research materials.The expression of AMACR,p63 and Ki-67 in 48 cases of prostate cancer,32 cases of high-grade prostatic intraepithelial neoplasia,26 cases of low-grade prostatic intraepithelial neoplasia and 50 cases of prostatic hyperplasia were detected by immunohistochemistry.The correlation between the expression of AMACR,p63 and Ki-67 and the clinical and pathological features of prostate cancer patients,as well as their diagnostic efficacy for prostate cancer were analyzed.ResultsThere were statistically significant differences in the positive expression rates of AMACR,p63 and Ki-67 among the samples of different groups(all P<0.05).The positive expression rate of AMACR in the biopsy samples of prostate cancer group was 100%,and the high expression rate was 81.25%,which was significantly higher than that of the other three groups.The negative expression rate of p63 was 97.92%,which was significantly higher than the other three groups.The positive expression rate of Ki-67 was 81.25%and the high expression rate was 54.17%,which was significantly higher than the other three groups.The expression of AMACR was related to tumor length,TNM stage,differentiation degree and Gleason score of prostate cancer patients.The high expression rate of AMACR in patients with tumor size≥1.5 cm,stageⅡtoⅢ,medium and highly differentiated tumors with Gleason score 8-10 was significantly higher than those with tumor size<1.5 cm,stageⅠ,low differentiation,and Gleason score 2-7(all P<0.05).Ki-67 expression was correlated with tumor length,differentiation degree,lymph node metastasis and Gleason score in prostate cancer patients.The high expression rate of Ki-67 in patients wit

关 键 词：前列腺肿瘤 免疫组织化学 Α-甲酰基辅酶A消旋酶 P63蛋白 KI-67抗原 

分 类 号：R737.25[医药卫生—肿瘤]