Shin M, Fujita M Q, Yasunaga Y, Miki T, Okuyama A, Aozasa K
Department of Pathology, Osaka University Medical School, Suita, Japan.
Int J Urol. 1998 May;5(3):237-42. doi: 10.1111/j.1442-2042.1998.tb00596.x.
Differential diagnosis of adenocarcinoma from other proliferative conditions in the prostate is often problematic. Immunohistochemistry using an antibody (34 beta E12) to high molecular weight cytokeratin, specifically present in basal cells of the prostate, could clearly demonstrate the presence or absence of these cells in the proliferating glands and thus provide an important clue in cancer diagnosis.
To examine the utility of immunostaining using 34 beta E12, we examined 88 equivocal lesions. Twenty lesions with apparently benign and malignant features were added as controls. We compared the morphologic features of these lesions with their immunoreactivities toward 34 beta E12 on a personal computer display following storage on the MICROPHOT-FXA system.
Proliferating glands in all 20 benign lesions had 34 beta E12-reactive basal cells, but none of the malignant lesions did. The equivocal lesions were categorized on morphologic grounds into 2 groups: possibly benign and possibly malignant. Forty-five (51.1%) of the 88 equivocal lesions, were positive for 34 beta E12. These included 35 of the 45 (77.8%) possibly benign lesions and 10 of the 43 (23.3%) possibly malignant lesions. Among the equivocal lesions, 10 considered possibly benign on morphologic grounds showed negative reactivities, and 10 considered possibly malignant showed positive reactivities. Even through comparison on the computer display, no difference in morphology could be discovered between the negative and positive lesions in either group.
Immunohistochemical procedures using 34 beta E12 are indispensable in the diagnosis of equivocal prostate lesions.
前列腺腺癌与其他增殖性疾病的鉴别诊断常常存在问题。使用针对高分子量细胞角蛋白的抗体（34βE12）进行免疫组织化学检测，该抗体特异性存在于前列腺基底细胞中，能够清晰显示增殖腺体中这些细胞的有无，从而为癌症诊断提供重要线索。
为了检测使用34βE12进行免疫染色的效用，我们检查了88例可疑病变。另外增加了20例具有明显良性和恶性特征的病变作为对照。在将这些病变存储于MICROPHOT-FXA系统后，我们在个人电脑显示屏上比较了它们的形态学特征及其对34βE12的免疫反应性。
所有20例良性病变中的增殖腺体均有34βE12反应性基底细胞，但恶性病变中均无。可疑病变根据形态学分为两组：可能良性和可能恶性。88例可疑病变中有45例（51.1%）对34βE12呈阳性。其中包括45例可能良性病变中的35例（77.8%）和43例可能恶性病变中的10例（23.3%）。在可疑病变中，10例形态学上认为可能良性的病变显示阴性反应，10例认为可能恶性的病变显示阳性反应。即使通过电脑显示屏进行比较，两组中阴性和阳性病变在形态学上也未发现差异。
使用34βE12的免疫组织化学方法在可疑前列腺病变的诊断中不可或缺。
