Human telomerase and alpha-methylacyl-coenzyme A racemase in prostatic carcinoma. A comparative immunohistochemical study.
Human telomerase and alpha-methylacyl-coenzyme A racemase in prostatic carcinoma. A comparative immunohistochemical study.
复制标题
DOI：
10.1016/j.anndiagpath.2005.09.021
复制
发表时间：
2006-08-01
影响因子：
2
通讯作者：
Dominguez-Malagon, Hugo
中科院分区：
文献类型：
--
作者：
Puebla-Mora, Ana Graciela;Heras, Alfonso;Dominguez-Malagon, Hugo
通过原位杂交检测的人端粒酶已被证明是诊断恶性肿瘤的有用工具，并且还通过逆转录酶-聚合酶链反应在多种肿瘤中进行了测试，例如肝细胞癌、黑色素瘤、结肠癌、胃癌、胆管癌、乳腺癌、间皮瘤、肺癌、女性道癌和前列腺癌。最近开发出了一种单克隆抗体（克隆 Tel-24），可以检测档案材料石蜡块中的人端粒酶逆转录酶 (hTERT)。已经用这种方法研究了宫颈癌、子宫内膜癌和乳腺癌，但其在前列腺癌中的价值尚未被探索。因此，我们使用石蜡包埋组织通过免疫组织化学研究良性和恶性前列腺病变。该研究的目的是与 α-甲基酰辅酶 A 消旋酶 (AMACR) (P504-S) 相比，确定 hTERT 在前列腺癌中的敏感性和特异性。选择了 55 个不同前列腺病变标本进行研究（43 个穿刺活检和 12 个经尿道切除术）；其中有 61 例恶性肿瘤（47 例浸润癌和 14 例高级别前列腺上皮内瘤变 [PIN]）和 29 例良性病变（10 例基底细胞增生、12 例结节性增生、4 例慢性前列腺炎和 3 例萎缩性腺体）。在 47 个浸润性腺癌中的 31 个中检测到 hTERT 核仁信号，在 14 个 PIN 中的 11 个中检测到 hTERT 核仁信号，在 27 个良性病变中均未检测到 hTERT 核仁信号（敏感性，71%；特异性，100%）。在 41 个浸润性腺癌中的 37 个、7 个 PIN 中的 7 个以及 22 个良性病变中的 6 个中发现了 AMACR 的弥漫性细胞质阳性（敏感性，91%；特异性，72%）。这些结果表明hTERT对恶性肿瘤具有高度特异性，没有假阳性病例；然而，它的灵敏度低于 AMACR。
Human telomerase detected by in situ hybridization has been demonstrated to be a useful tool for the diagnosis of malignancy and has also been tested by reverse transcriptase-polymerase chain reaction in several tumors such as hepatic cell carcinoma, melanoma, colonic carcinoma, gastric carcinoma, biliary carcinoma, breast carcinoma, mesothelioma, lung carcinoma, female tract carcinoma, and prostatic carcinoma. A monoclonal antibody (clone Tel-24) that allows for the detection of human telomerase reverse transcriptase (hTERT) in paraffin blocks of archival material has recently been developed. Carcinomas of cervix, endometrium, and breast have been studied by this method, but its value in prostatic carcinoma has not been explored; for that reason, we studied benign and malignant prostatic lesions by immunohistochemistry using paraffin embedded tissue. The aim of the study was to define the sensitivity and specificity of hTERT in prostate cancer, in comparison with alpha-methylacyl-coenzyme A racemase (AMACR) (P504-S). Fifty-five specimens of diverse prostatic lesions were selected for study (43 needle biopsies and 12 transurethral resections); there were 61 malignancies (47 infiltrating carcinomas and 14 high-grade prostatic intraepithelial neoplasias [PIN]) and 29 benign lesions (10 basal cell hyperplasias, 12 nodular hyperplasias, 4 chronic prostatitis, and 3 atrophic glands). Signal for hTERT nucleolar was detected in 31 of 47 infiltrating adenocarcinomas, in 11 of 14 PIN, and in none of 27 benign lesions (sensitivity, 71%; specificity, 100%). Diffuse cytoplasmic positivity for AMACR was found in 37 of 41 infiltrating adenocarcinomas, in 7 of 7 PIN, and in 6 of 22 benign lesions (sensitivity, 91%; specificity, 72%). These results indicate that hTERT is highly specific of malignancy, with no false-positive cases; however, it had lower sensitivity than AMACR.