Department of Pathology, Shizuoka City Shimizu Hospital, Shizuoka, Japan.
Prostate. 2012 Jul 1;72(10):1150-6. doi: 10.1002/pros.22464. Epub 2011 Nov 29.
Because there have been no reports on the incidence and expressions and mutations of KIT and PDGFRA in small cell neuroendocrine carcinoma (SCNEC) of the prostate, the author surveyed archival specimens of 2,642 prostatic specimens (biopsy, 1,503 cases; transurethral resection, 1,009 cases; prostatectomy, 130 cases). Of these, 706 cases were malignant tumors. In equivocal cases (n = 16) of Gleason 5 adenocarcinoma resembling SCNEC, several neuroendocrine markers were immunohistochemically examined. As the results, four cases of SCNEC were identified; therefore the incidence of SCNEC was 0.5% of all prostatic malignancies. All the four cases were biopsies. The remaining 686 cases were adenocarcinomas. In case 1 (50 years of age), the SCNEC tumor cells were positive for cytokeratin, P504S, synaptophysin, KIT, and PDGFRA, but negative for PSA, neuron specific enolase, CD56, and TTF-1. In case 2 (70 years of age), the tumor cells were positive for cytokeratin, PSA, P504S, chromogranin, and synaptophysin, but negative for neuron-specific enolase, CD56, TTF-1, KIT, and PDGFRA. In case 3 (72 years of age), the SCNEC tumor cells were positive for cytokeratin, PSA, P504S, synaptophysin, CD56, KIT, and PDGFRA, but negative for neuron-specific enolase, chromogranin, and TTF-1. In case 4 (81 years of age), the SCNEC tumor cell were positive for cytokeratin, PSA, P504S, chromogranin, synaptophysin, neuron-specific enolase, KIT, and PDGFRA, but negative for CD56 and TTF-1. A molecular genetic analysis using PCR-direct sequencing showed no mutations of KIT (exons 9, 11, 13, and 17) and PDGFRA (exons 12 and 18) genes in three informative cases of SCNEC. The present cases were the first of prostatic SCNEC with an examination of KIT and PDGFRA expression and KIT and PDFGRA gene mutations.
由于目前尚无关于前列腺小细胞神经内分泌癌（SCNEC）中 KIT 和 PDGFRA 的发生率、表达和突变的报道，作者调查了 2642 例前列腺标本的存档标本（活检 1503 例；经尿道前列腺切除术 1009 例；前列腺切除术 130 例）。其中，706 例为恶性肿瘤。在类似 SCNEC 的 Gleason 5 腺癌的可疑病例（n=16）中，使用免疫组织化学方法检查了几种神经内分泌标志物。结果，发现 4 例 SCNEC；因此，SCNEC 的发生率为所有前列腺恶性肿瘤的 0.5%。这 4 例均为活检。其余 686 例为腺癌。在第 1 例（50 岁）中，SCNEC 肿瘤细胞对细胞角蛋白、P504S、突触素、KIT 和 PDGFRA 呈阳性，但对 PSA、神经元特异性烯醇化酶、CD56 和 TTF-1 呈阴性。在第 2 例（70 岁）中，肿瘤细胞对细胞角蛋白、PSA、P504S、嗜铬粒蛋白和突触素呈阳性，但对神经元特异性烯醇化酶、CD56、TTF-1、KIT 和 PDGFRA 呈阴性。在第 3 例（72 岁）中，SCNEC 肿瘤细胞对细胞角蛋白、PSA、P504S、突触素、CD56、KIT 和 PDGFRA 呈阳性，但对神经元特异性烯醇化酶、嗜铬粒蛋白和 TTF-1 呈阴性。在第 4 例（81 岁）中，SCNEC 肿瘤细胞对细胞角蛋白、PSA、P504S、嗜铬粒蛋白、突触素、神经元特异性烯醇化酶、KIT 和 PDGFRA 呈阳性，但对 CD56 和 TTF-1 呈阴性。使用 PCR 直接测序的分子遗传学分析显示，在 3 例信息丰富的 SCNEC 中，KIT（外显子 9、11、13 和 17）和 PDGFRA（外显子 12 和 18）基因均未发生突变。目前的病例是首例对前列腺 SCNEC 进行 KIT 和 PDGFRA 表达及 KIT 和 PDFGRA 基因突变检测的病例。
