Hu Yang, Dan Luo, Shikun Yang, Junbo Lian, Shuangjie Huo, Liru Dong
Department of Pathology, Hebei Provincial Corps Hospital of Chinese People's Armed Police Force, Shijiazhuang, Hebei Province, 050081, China.
Department of Pathology, North China University of Science and Technology Affiliated Hospital, Tangshan, Hebei Province, 063000, China.
Discov Oncol. 2025 Jun 23;16(1):1183. doi: 10.1007/s12672-025-02984-4.
This study aimed to evaluate the diagnostic utility of GATA3 and CD138 as basal compartment markers in differentiating benign prostatic hyperplasia (BPH) from prostate cancer (PCa).
Immunohistochemical analysis of GATA3, CD138, CK34βE12, and P63 was performed on 131 prostate tissue samples (77BPH,54PCa). Expression profiles, sensitivity, specificity, and Cohen's Kappa agreement were compared between markers.
In BPH samples, nuclear expression of GATA3 and p63 showed identical positive rates (92.21%, 95%CI: 89.3-94.8%), while CD138 (antibody concentration 1:200) and CK34βE12 (antibody concentration 1:100) demonstrated cytoplasmic/membranous positivity in 96.10% (93.4-98.1%) and 93.51% (90.2-95.9%) of cases respectively. All markers exhibited complete negativity (H-score < 5) in PCa basal cells.GATA3 achieved 100% diagnostic concordance (95%CI: 97.8-100%) with p63 in both BPH and PCa (perfect agreement, κ = 1, p < 0.001 by McNemar-Bowker test). Compared to CK34βE12:In BPH: Sensitivity = 98.61% (97.2-99.4%), Specificity = 100% (NPV 96.3%);In PCa: Diagnostic accuracy = 100% (AUC 1.0);(Inter-rater reliability κ = 0.902-1.0, weighted least squares method).CD138 achieved 100% analytic sensitivity but suboptimal specificity (57.1%, 95%CI: 44.8-68.7%) in BPH when referenced against p63/CK34βE12, while achieving perfect discrimination (κ = 0.926, p = 7.6 × 10) in PCa cohorts.
GATA3 and CD138 demonstrate basal compartment enrichment patterns that complement conventional markers for PCa diagnosis (accuracy 96-100%). Their nuclear (GATA3) and cytoplasmic (CD138) localization enhances reliability, particularly in cases with fixation artifacts or ambiguous morphology.
本研究旨在评估GATA3和CD138作为基底细胞标志物在鉴别良性前列腺增生（BPH）和前列腺癌（PCa）中的诊断效用。
对131例前列腺组织样本（77例BPH，54例PCa）进行GATA3、CD138、CK34βE12和P63的免疫组化分析。比较各标志物之间的表达谱、敏感性、特异性和Cohen's Kappa一致性。
在BPH样本中，GATA3和p63的核表达阳性率相同（92.21%，95%CI：89.3 - 94.8%），而CD138（抗体浓度1:200）和CK34βE12（抗体浓度1:100）分别在96.10%（93.4 - 98.1%）和93.51%（90.2 - 95.9%）的病例中显示胞质/膜阳性。所有标志物在PCa基底细胞中均表现为完全阴性（H评分＜5）。GATA3在BPH和PCa中与p63的诊断一致性均达到100%（95%CI：97.8 - 100%）（完全一致，McNemar - Bowker检验κ = 1，p＜0.001）。与CK34βE12相比：在BPH中：敏感性 = 98.61%（97.2 - 99.4%），特异性 = 100%（阴性预测值96.3%）；在PCa中：诊断准确性 = 100%（AUC 1.0）；（评分者间可靠性κ = 0.902 - 1.0，加权最小二乘法）。以p63/CK34βE12为参照时，CD138在BPH中的分析敏感性达到100%，但特异性欠佳（57.1%，95%CI：44.8 - 68.7%），而在PCa队列中实现了完美区分（κ = 0.926，p = 7.6×10）。
GATA3和CD138显示出基底细胞富集模式，可补充用于PCa诊断的传统标志物（准确性96 - 100%）。它们的核（GATA3）和胞质（CD138）定位提高了可靠性，特别是在存在固定伪像或形态不明确的病例中。
