NKX3.1 and PSMA are sensitive diagnostic markers for prostatic carcinoma in bone metastasis after decalcification of specimens.
NKX3.1 and PSMA are sensitive diagnostic markers for prostatic carcinoma in bone metastasis after decalcification of specimens.
复制标题
NKX3.1和PSMA是标本脱钙后前列腺癌骨转移的敏感诊断标志物。
DOI：
--
复制
发表时间：
2018
影响因子：
1.2
通讯作者：
F. Deng
中科院分区：
文献类型：
--
作者：
Hong;S. Guma;J. Melamed;Ming Zhou;Peng Lee;F. Deng
背景
前列腺特异性抗原（PSA）、前列腺特异性膜抗原（PSMA）和NKX3.1是经常用于诊断转移性前列腺癌（mPCa）的敏感和前列腺特异性标志物。国际泌尿病理学会建议使用PSA作为识别PCa的初始免疫组织化学（IHC）标记物。如果肿瘤PSA不明确/弱/阴性，则建议P501 S和NKX3.1染色。然而，没有具体的研究试图比较这些标志物的染色灵敏度后标本脱钙骨标本。在这项研究中，我们分析了PSA，PSMA和NKX3.1在脱钙后的mPCa骨标本中的染色敏感性。
设计
我们研究了24例骨转移性前列腺癌。所有病例在H&E染色和IHC检查之前脱钙24至48小时。8例为椎体活检，5例为股骨活检，4例为髂骨活检，2例为肋骨活检，3例为耻骨支活检，1例为骶骨活检，1例为颅骨活检。PSA、PSMA和NKX3.1的IHC染色模式定义如下：阴性（无染色）、局灶性阳性（≤ 10%）和弥漫性阳性（≥ 10%）。局灶性和弥漫性阳性均被认为是阳性。
结果
PSA阳性率为64%（14/22），PSMA和NKX3.1均为阳性（分别为17/17和24/24）。经卡方检验，前列腺癌骨转移脱钙标本中PSMA染色阳性率明显高于PSA染色阳性率（χ 2检验：5.389，P = 0.0203）。当通过卡方检验分析时，前列腺癌转移到骨的脱钙样本中NKX3.1染色阳性的频率也在统计学上高于PSA染色的频率（卡方统计量：10.56; P = 0.0012）。当比较PSMA和NKX3.1阳性染色时，NKX3.1倾向于以更高的频率呈弥漫性阳性。但是，该差异无统计学意义。
结论
本研究表明，对于脱钙后骨骼中的mPCa，PSMA和NKX3.1是比PSA更敏感的标志物。我们建议使用PSMA和NKX3.1而不是PSA作为IHC标记物来确认骨中的mPCa。
BACKGROUND
Prostate specific antigen (PSA), prostate specific membrane antigen (PSMA), and NKX3.1 are sensitive and prostate-specific markers frequently used for the diagnosis of metastatic prostate cancer (mPCa). International Society of Urological Pathology recommends use of PSA as the initial immunohistochemical (IHC) marker to identify PCa. If the tumor is equivocal/weak/negative for PSA, then P501S and NKX3.1 stains are suggested. However, no specific studies have attempted to compare the staining sensitivity of these markers post specimen decalcification of bone specimens. In this study, we analyze the staining sensitivity of PSA, PSMA and NKX3.1 in bone specimens with mPCa after decalcification.
DESIGN
We studied 24 cases of mPCa to the bone. All cases were decalcified for 24 to 48 hours prior to H&E staining and IHC workup. Eight cases were biopsies from vertebral bodies, five were from the femur, four came from the iliac bone, two were from ribs, three were from the pubic ramus, one was from the sacrum and one was from the skull. IHC staining pattern of PSA, PSMA and NKX3.1 was defined as follows: negative (no staining), focally positive (≤ 10%) and diffusely positive (≥ 10%). Focal and diffuse positivity are both considered positive.
RESULTS
PSA was positive in 64% (14/22) cases, while PSMA and NKX3.1 were positive in all cases (17/17 and 24/24, respectively). The frequency of positive PSMA staining in decalcified samples of prostatic carcinoma metastatic to the bone is statistically higher than that of PSA staining, when analyzed by the Chi-square test (Chi-square statistic: 5.389; P = 0.0203). The frequency of positive NKX3.1 staining in decalcified samples of prostatic carcinoma metastatic to the bone is also statistically higher than that of PSA staining, when analyzed by the Chi-square test (Chi-square statistic: 10.56; P = 0.0012). When comparing PSMA and NKX3.1 positive staining, NKX3.1 tended to be diffusely positive at a higher frequency. However, this difference was not statistically significant.
CONCLUSION
This study demonstrates that PSMA and NKX3.1 are more sensitive markers than PSA for mPCa to the bone following decalcification. We recommend use of PSMA and NKX3.1, rather than PSA, as the IHC markers to confirm mPCa to the bone.
影响因子：
3.3
作者：
Roudier, MP;True, LD;Vessella, RL
通讯作者：
Vessella, RL
影响因子：
11.2
作者：
C. Bowen;L. Bubendorf;H. Voeller;R. Slack;N. Willi;G. Sauter;Th. Gasser;P. Koivisto;E. Lack-E.
通讯作者：
C. Bowen;L. Bubendorf;H. Voeller;R. Slack;N. Willi;G. Sauter;Th. Gasser;P. Koivisto;E. Lack-E.