Kristiansen Ilka, Stephan Carsten, Jung Klaus, Dietel Manfred, Rieger Anja, Tolkach Yuri, Kristiansen Glen
Institute of Pathology, University Hospital Bonn, 53127 Bonn, Germany.
Department of Urology, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany.
Int J Mol Sci. 2017 May 29;18(6):1151. doi: 10.3390/ijms18061151.
Determining the origin of metastases is an important task of pathologists to allow for the initiation of a tumor-specific therapy. Recently, homeobox protein Hox-B13 (HOXB13) has been suggested as a new marker for the detection of prostatic origin. The aim of this study was to evaluate the diagnostic sensitivity of HOXB13 in comparison to commonly used immunohistochemical markers for prostate cancer.
Histologically confirmed prostate cancer lymph node metastases from 64 cases were used to test the diagnostic value of immunohistochemical markers: prostate specific antigen (PSA), Prostatic acid phosphatase (PSAP), prostate specific membrane antigen (PSMA), homeobox gene , prostein, androgen receptor (AR), HOXB13, and ETS-related gene (ERG). All markers were evaluated semi-quantitatively using Remmele's immune reactive score.
The detection rate of prostate origin of metastasis for single markers was 100% for NKX3.1, 98.1% for AR, 84.3% for PSMA, 80.8% for PSA, 66% for PSAP, 60.4% for HOXB13, 59.6% for prostein, and 50.0% for ERG.
Our data suggest that HOXB13 on its own lacks sensitivity for the detection of prostatic origin. Therefore, this marker should be only used in conjunction with other markers, preferably the highly specific PSA. The combination of PSA with NKX3.1 shows a higher sensitivity and thus appears preferable in this setting.
确定转移灶的起源是病理学家的一项重要任务，以便开展肿瘤特异性治疗。最近，有人提出同源框蛋白Hox - B13（HOXB13）可作为检测前列腺起源的新标志物。本研究的目的是评估HOXB13与常用的前列腺癌免疫组化标志物相比的诊断敏感性。
采用64例经组织学证实的前列腺癌淋巴结转移病例来检测免疫组化标志物的诊断价值：前列腺特异性抗原（PSA）、前列腺酸性磷酸酶（PSAP）、前列腺特异性膜抗原（PSMA）、同源框基因、前列腺素、雄激素受体（AR）、HOXB13和ETS相关基因（ERG）。使用雷姆勒免疫反应评分对所有标志物进行半定量评估。
单个标志物检测转移灶前列腺起源的阳性率分别为：NKX3.1为100%，AR为98.1%，PSMA为84.3%，PSA为80.8%，PSAP为66%，HOXB13为60.4%，前列腺素为59.6%，ERG为50.0%。
我们的数据表明，单独使用HOXB13检测前列腺起源缺乏敏感性。因此，该标志物应仅与其他标志物联合使用，最好是高度特异性的PSA。PSA与NKX3.1联合显示出更高的敏感性，因此在这种情况下似乎更可取。
