Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, USA.
Diagn Pathol. 2010 Sep 23;5:63. doi: 10.1186/1746-1596-5-63.
Prostate carcinoma is among the most common solid tumors to secondarily involve the male breast. Prostate specific antigen (PSA) and prostate-specific acid phosphatase (PSAP) are expressed in benign and malignant prostatic tissue, and immunohistochemical staining for these markers is often used to confirm the prostatic origin of metastatic carcinoma. PSA expression has been reported in male and female breast carcinoma and in gynecomastia, raising concerns about the utility of PSA for differentiating prostate carcinoma metastasis to the male breast from primary breast carcinoma. This study examined the frequency of PSA, PSAP, and hormone receptor expression in male breast carcinoma (MBC), female breast carcinoma (FBC), and gynecomastia.
Immunohistochemical staining for PSA, PSAP, AR, ER, and PR was performed on tissue microarrays representing six cases of gynecomastia, thirty MBC, and fifty-six FBC.
PSA was positive in two of fifty-six FBC (3.7%), focally positive in one of thirty MBC (3.3%), and negative in the five examined cases of gynecomastia. PSAP expression was absent in MBC, FBC, and gynecomastia. Hormone receptor expression was similar in males and females (AR 74.1% in MBC vs. 67.9% in FBC, p = 0.62; ER 85.2% vs. 68.5%, p = 0.18; and PR 51.9% vs. 48.2%, p = 0.82).
PSA and PSAP are useful markers to distinguish primary breast carcinoma from prostate carcinoma metastatic to the male breast. Although PSA expression appeared to correlate with hormone receptor expression, the incidence of PSA expression in our population was too low to draw significant conclusions about an association between PSA expression and hormone receptor status in breast lesions.
前列腺癌是最常见的继发型男性乳腺癌实体肿瘤之一。前列腺特异抗原（PSA）和前列腺特异性酸性磷酸酶（PSAP）在良性和恶性前列腺组织中表达，免疫组织化学染色常用于这些标志物以确认转移性癌的前列腺起源。PSA 在男性和女性乳腺癌和男性乳房发育中均有表达，这引起了人们对 PSA 用于区分前列腺癌转移至男性乳房与原发性乳腺癌的实用性的关注。本研究检查了男性乳腺癌（MBC）、女性乳腺癌（FBC）和男性乳房发育症中 PSA、PSAP 和激素受体表达的频率。
对代表 6 例男性乳房发育症、30 例 MBC 和 56 例 FBC 的组织微阵列进行 PSA、PSAP、AR、ER 和 PR 的免疫组织化学染色。
56 例 FBC 中有 2 例（3.7%）PSA 阳性，30 例 MBC 中有 1 例（3.3%）局灶性阳性，5 例检查的男性乳房发育症均为阴性。PSAP 在 MBC、FBC 和男性乳房发育症中均无表达。男性和女性的激素受体表达相似（MBC 中的 AR 为 74.1%，FBC 为 67.9%，p = 0.62；ER 为 85.2%，FBC 为 68.5%，p = 0.18；PR 为 51.9%，FBC 为 48.2%，p = 0.82）。
PSA 和 PSAP 是区分原发性乳腺癌和前列腺癌转移至男性乳腺癌的有用标志物。尽管 PSA 表达似乎与激素受体表达相关，但在我们的人群中 PSA 表达的发生率太低，无法就 PSA 表达与乳房病变中激素受体状态之间的关联得出重要结论。
