Molinié Vincent, Hervé Jean-Marie, Lebret Thierry, Lugagne-Delpon Pierre-Marie, Saporta François, Yonneau Laurent, Botto Henry, Baglin Anne Catherine
Service de Pathologie, Hôpital Foch, Suesnes.
Ann Pathol. 2004 Feb;24(1):6-16. doi: 10.1016/s0242-6498(04)93902-8.
Numerous lesions of the prostate, such as atrophy, adenomatous atypical hyperplasia (adenosis) or PIN can be misdiagnosed with prostatic cancer, and confused with ASAP, leading to perform additional biopsies. In such lesions, the pathologist can perform an immunohistochemical study with the anti-high molecular weight cytokeratin antibody CK903 (34bE12), which confirms the absence of basal cells and supports the diagnosis of prostatic cancer.
To compare markers of basal cells (cytokeratin 5/6, p63) and the marker of prostatic carcinomatous glands (p504s) or alpha methylacyl-CoA racemase (AMACR).
Retrospective study of 44 cases of paraffin-embedded prostatic specimens (36 biopsies, 4 PER, 1 adenomectomy and 3 radical prostatectomies), consisting in 20 cases of prostatic carcinomas (2 intraductal, 12 Gleason 6 (3+3), 4 Gleason 7 (4+3), 2 Gleason 8 (4+4)), 11 ASAP, 9 PIN (2 low grade, 7 high grade (2 isolated)), and 10 benign lesions (8 atrophy, 1 atypical adenomatous hyperplasia and 1 case of clear cell cribriform hyperplasia). All cases were tested with antibodies to CK 5/6, and with a cocktail to p63 and p504s, after heat antigenic retrieval on NEXES Ventana processor.
Basal cells of normal prostatic glands stained with CK5/6 and p63 in 91,3% and 100% of cases, independently from the fixation procedure (Bouin or Formalin). Carcinomas had a p63-/p504s+ profile, PIN were p63+/p504s+, and benign lesions were p63+/p504s-. We observed an increase in sensitivity: p63/p504s (100%), CK5/6 (80%), p63 (90%), p504s (95%), and specificity: p53/p504s (90%), CK5/6 (87.5%), p63 (90.5%), p504s (90.9%).
Our results show that the use of a cocktail to p63/p504s is more specific than the use of CK5/6 alone this technique supports a diagnosis of prostatic cancer in 40% of cases previously considered as ASAP.
前列腺的许多病变，如萎缩、腺瘤样非典型增生（腺病）或前列腺上皮内瘤变（PIN），可能被误诊为前列腺癌，并与非典型小腺泡增生（ASAP）混淆，从而导致进行额外的活检。在这些病变中，病理学家可以使用抗高分子量细胞角蛋白抗体CK903（34bE12）进行免疫组织化学研究，该研究可证实基底细胞的缺失并支持前列腺癌的诊断。
比较基底细胞标志物（细胞角蛋白5/6、p63）和前列腺癌腺标志物（p504s）或α-甲基酰基辅酶A消旋酶（AMACR）。
对44例石蜡包埋的前列腺标本（36例活检、4例前列腺穿刺活检、1例腺瘤切除术和3例根治性前列腺切除术）进行回顾性研究，其中包括20例前列腺癌（2例导管内癌、12例Gleason 6级（3+3）、4例Gleason 7级（4+3）、2例Gleason 8级（4+4））、11例ASAP、9例PIN（2例低级别、7例高级别（2例孤立性））和10例良性病变（8例萎缩、1例非典型腺瘤样增生和1例透明细胞筛状增生）。在NEXES Ventana处理器上进行热抗原修复后，所有病例均用抗CK 5/6抗体以及p63和p504s混合抗体进行检测。
正常前列腺腺泡的基底细胞在91.3%和100%的病例中分别被CK5/6和p63染色，与固定方法（Bouin液或福尔马林）无关。癌表现为p63阴性/p504s阳性，PIN为p63阳性/p504s阳性，良性病变为p63阳性/p504s阴性。我们观察到敏感性增加：p63/p504s（100%）、CK5/6（80%）、p63（90%）、p504s（95%），以及特异性增加：p53/p504s（90%）、CK5/6（87.5%）、p63（90.5%）、p504s（90.9%）。
我们的结果表明，使用p63/p504s混合抗体比单独使用CK5/6更具特异性，该技术在40%先前被视为ASAP的病例中支持前列腺癌的诊断。
