Remo Andrea, Pancione Massimo, Zanella Caterina, Manfrin Erminia
*Department of Pathology "Mater Salutis" Hospital, Legnago ‡Department of Pathology "G.B. Rossi" Hospital, University of Verona, Verona †Department of Science and Technology, University of Sannio, Benevento, Italy.
Appl Immunohistochem Mol Morphol. 2016 Mar;24(3):201-6. doi: 10.1097/PAI.0000000000000171.
Prostatic specimens occasionally may contain proliferative foci of the small atypical acini that display some but not all features of prostate carcinoma. p504s is the only prostatic cancer (PC)-specific marker that, in combination with basal cell markers, help in the diagnosis of malignant lesions. Very little is known about the diagnostic importance of p16 in primary prostate carcinoma and nonmalignant elements.
We recruited 137 of routinely diagnostic prostatic specimens (between 2009 and 2013), which consisted of 21 prostatectomy, 15 transurethral prostatic resection, and 101 needle biopsy. We evaluated p16, in comparison with p504s, in prostatic carcinoma and benign glands. In this study, both nuclear and cytoplasmatic p16 expression were considered positive.
We observed p16 expression in 86% of PC specimens and 16% of benign elements (P=0.001). Interestingly, p16 alone retained a high diagnostic potential in prostatectomy (95%) and in needle biopsy (84%), exhibiting a close association with PC. p504s had a high sensitivity (97%) and predictive negative value (98%) but a low specificity (71%) and predictive positive value (63%). In contrast, p16-positive expression showed a higher specificity (84%) and predictive positive value (74%) than p504s. Two prostatic carcinoma negative for p504s were positive for p16, whereas 7 cases negative for p16 were positive for p504s, and notably none was negative for both markers. In prostatectomy, p16 showed a higher diagnostic accuracy but not on transurethral prostatic resection. In needle biopsies, both markers were complementary, indicating that their combined detection may help in performing an accurate diagnosis.In conclusion, our data suggest that p16 expression is significantly enhanced in prostate carcinoma as compared with nonmalignant elements. Our results provide evidence that p16 and p504s together could improve the diagnosis of PC in prostatectomy and needle biopsies.
前列腺标本偶尔可能含有小的非典型腺泡增生灶，这些增生灶具有前列腺癌的部分而非全部特征。p504s是唯一的前列腺癌（PC）特异性标志物，与基底细胞标志物联合使用有助于诊断恶性病变。关于p16在原发性前列腺癌和非恶性成分中的诊断重要性，人们了解甚少。
我们收集了137例常规诊断的前列腺标本（2009年至2013年），包括21例前列腺切除术标本、15例经尿道前列腺切除术标本和101例穿刺活检标本。我们将前列腺癌和良性腺体中的p16与p504s进行了比较评估。在本研究中，细胞核和细胞质p16表达均被视为阳性。
我们观察到86%的PC标本和16%的良性成分中有p16表达（P = 0.001）。有趣的是，单独的p16在前列腺切除术标本（95%）和穿刺活检标本（84%）中仍具有较高的诊断潜力，与PC密切相关。p504s具有高敏感性（97%）和阴性预测值（98%），但特异性低（71%）和阳性预测值（63%）。相比之下，p16阳性表达比p504s具有更高的特异性（84%）和阳性预测值（74%）。2例p504s阴性的前列腺癌p16阳性，而7例p16阴性的病例p504s阳性，值得注意的是，没有病例两种标志物均为阴性。在前列腺切除术中，p16显示出更高的诊断准确性，但在经尿道前列腺切除术中则不然。在穿刺活检中，两种标志物具有互补性，表明联合检测可能有助于进行准确诊断。总之，我们的数据表明，与非恶性成分相比，前列腺癌中p16表达显著增强。我们的结果提供了证据，表明p16和p504s共同可改善前列腺切除术和穿刺活检中PC的诊断。
