THE UTILITY OF BASAL CELL-SPECIFIC ANTI-CYTOKERATIN ANTIBODY (34-BETA-E12) IN THE DIAGNOSIS OF PROSTATE-CANCER - A REVIEW OF 228 CASES
THE UTILITY OF BASAL CELL-SPECIFIC ANTI-CYTOKERATIN ANTIBODY (34-BETA-E12) IN THE DIAGNOSIS OF PROSTATE-CANCER - A REVIEW OF 228 CASES
复制标题
DOI：
10.1097/00000478-199503000-00002
复制
发表时间：
1995-03-01
影响因子：
5.6
通讯作者：
EPSTEIN, JI
中科院分区：
文献类型：
--
作者：
WOJNO, KJ;EPSTEIN, JI
通过标准免疫组织化学技术，基底细胞特异性抗细胞角蛋白抗体（34 β 12）修饰良性前列腺上皮的基底细胞，而前列腺腺癌对该抗体缺乏免疫反应性。我们回顾了我们使用这种抗体的经验，以确定它在前列腺腺癌诊断中的效用，以及它在三级医疗中心的使用模式。在1989年1月至1993年4月期间，共有5262名男性的7242份前列腺标本在约翰霍普金斯医院就诊。基底细胞特异性细胞角蛋白（34 β 12）免疫染色最初用于228例289个可疑区域的诊断目的；其中45%的病例是在咨询中看到的。使用34 β E12的病例分布为52%穿刺活检，32%经尿道前列腺切除术（TURPs）， 13%根治性前列腺切除术和3%开放式摘除。在此期间，这些手术占所有针活检的2.8%，占所有turp的7.2%，占所有根治性前列腺切除术的1.7%，占所有剜出的3.5%。在本研究中，在不了解原始诊断的情况下复查苏木精和伊红染色，支持诊断，检查34 β E12染色，并确定最终诊断。34 β E12染色建立（14%），证实（58%）或改变（2%）我们的首选诊断，而18%保持或变得模棱两可。34 β E12染色在8%的病例中无效，但我们认为即使没有染色的帮助，我们仍然能够做出最终诊断。在可疑病灶中，34 β E12的鉴别诊断为癌与非典型腺体病灶（44%）、腺病（39%）、前列腺上皮内瘤变（PIN）（8%）、基底细胞增生（5%）和萎缩（4%）。然而，34 β E12仅用于所有腺病和基底细胞增生病例的15-20%
Basal cell-specific anti-cytokeratin antibody (34 beta 12) decorates the basal cells of benign prostatic epithelium by standard immunohistochemical techniques, whereas adenocarcinoma of the prostate lacks immunoreactivity with this antibody. We reviewed our experience with this antibody to determine its utility in the diagnosis of adenocarcinoma of the prostate as well as its pattern of usage at a tertiary medical center. In all, 7,242 prostate specimens from 5,262 men were seen at Johns Hopkins Hospital between 1/89 and 4/93. Immunostaining for basal cell-specific cytokeratin (34 beta 12) was originally used for diagnostic purposes in 289 questionable areas from 228 cases; 45% of these cases were seen in consultation. The distribution of cases using 34 beta E12 was 52% needle biopsies, 32% transurethral prostatic resections (TURPs), 13% radical prostatectomies, and 3% open enucleations. These procedures constituted 2.8% of all needle biopsies, 7.2% of all TURPs, 1.7% of all radical prostatectomies, and 3.5% of all enucleations seen during this time period. For this study the hematoxylin and eosin stain was reviewed without knowledge of the original diagnosis, a diagnosis was favored, the 34 beta E12 stain was examined, and a final diagnosis was determined. The 34 beta E12 stain established (14%), confirmed (58%), or changed (2%) our favored diagnoses, while 18% remained or became equivocal. The 34 beta E12 stain was of no use in 8% of the cases, yet we felt we were still able to render a final diagnosis even without the help of the stain. The differential diagnoses in the questionable foci using 34 beta E12 were cancer versus focus of atypical glands (44%), adenosis (39%), prostatic intraepithelial neoplasia (PIN) (8%), basal cell hyperplasia (5%), and atrophy (4%). However, 34 beta E12 was used in only 15-20% of all cases of adenosis and basal cell hyperplasia and in