Immunohistochemical differentiation of high-grade prostate carcinoma from urothelial carcinoma
Immunohistochemical differentiation of high-grade prostate carcinoma from urothelial carcinoma
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DOI：
10.1097/pas.0b013e31802f5d33
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发表时间：
2007-08-01
影响因子：
5.6
通讯作者：
Epstein, Jonathan I.
中科院分区：
文献类型：
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作者：
Chuang, Ai-Ying;DeMarzo, Angelo M.;Epstein, Jonathan I.
高级别前列腺癌和浸润性高级别尿路上皮癌之间的组织学区分可能很困难，并且具有重要意义，因为每种疾病的治疗可能非常不同（即前列腺癌的激素治疗和尿路上皮癌的化疗）。采用组织微阵列（TMAs）研究了新的和已建立的前列腺和尿路上皮标志物的免疫组化。研究的前列腺标志物包括：前列腺特异性抗原（PSA）、前列腺素（P501）、前列腺特异性膜抗原（PSMA）、NKX3.1（雄激素相关肿瘤抑制基因）和proPSA（pPSA）（PSA的前体形式）。“尿路上皮标志物”包括高分子量细胞角蛋白（HMWCK）、p63、血栓调节蛋白和S100 P（胎盘S100）。TMA包含38例低分化前列腺癌[Gleason评分8（n = 2），Gleason评分9（n = 18），Gleason评分10（n = 18）]和35例高级别浸润性尿路上皮癌，分别来自根治性膀胱切除术和膀胱癌标本。每个病例有2至8个组织点（直径0.6 mm）。如果一个病例的所有斑点均显示阴性染色，则该病例被称为阴性。标记前列腺癌的敏感性为PSA（97.4%）、P501S（100%）、PSMA（92.1%）、NKX3.1（94.7%）和pPSA（94.7%）。由于PSA对TMA的敏感性很高，我们选择了另外41例低分化原发性（N = 36）和转移性（N = 5）前列腺癌，这些前列腺癌在诊断时显示出不同的PSA染色，并对常规组织切片进行了免疫组织化学。与平均18.8%的PSA中强阳性细胞相比，P501S、PSMA和NKX3.1的阳性率分别为42.5%、53.7%和52.9%。所有前列腺标志物均表现出良好的特异性。HMWCK、p63、血栓调节蛋白和S100 P在标记TMAs中的高级别浸润性尿路上皮癌时显示较低的敏感性，分别为91.4%、82.9%、68.6%和71.4%染色。这些尿路上皮标志物相对特异，只有少数前列腺癌显示分散的（
The histologic distinction between high-grade prostate cancer and infiltrating high-grade urothelial cancer may be difficult, and has significant implications because each disease may be treated very differently (ie, hormone therapy for prostate cancer and chemotherapy for urothelial cancer). Immunohistochemistry of novel and established prostatic and urothelial markers using tissue microarrays (TMAs) were studied. Prostatic markers studied included: prostate-specific antigen (PSA), prostein (P501s), prostate-specific membrane antigen (PSMA), NKX3.1 (an androgen-related tumor suppressor gene), and proPSA (pPSA) (precursor form of PSA). "Urothelial markers" included high molecular weight cytokeratin (HMWCK), p63, thrombomodulin, and S100P (placental S100). TMAs contained 38 poorly differentiated prostate cancers [Gleason score 8 (n = 2), Gleason score 9 (n 18), Gleason score 10 (n = 18)] and 35 high-grade invasive urothelial carcinomas from radical prostatectomy and cystectomy specimens, respectively. Each case had 2 to 8 tissue spots (0.6-mm diameter). If all spots for a case showed negative staining, the case was called negative. The sensitivities for labeling prostate cancers were PSA (97.4%), P501S (100%), PSMA (92.1%), NKX3.1 (94.7%), and pPSA (94.7%). Because of PSA's high sensitivity on the TMA, we chose 41 additional poorly differentiated primary (N = 36) and metastatic (N = 5) prostate carcinomas which showed variable PSA staining at the time of diagnosis and performed immunohistochemistry on routine tissue sections. Compared to PSA, which on average showed 18.8% of cells with moderate to strong positivity, cases stained for P501S, PSMA, and NKX3.1 had on average 42.5%, 53.7%, 52.9% immunoreactivity, respectively. All prostatic markers showed excellent specificity. HMWCK, p63, thrombomodulin, and S100P showed lower sensitivities in labeling high-grade invasive urothelial cancer in the TMAs with 91.4%, 82.9%, 68.6%, and 71.4% staining, respectively. These urothelial markers were relatively specific with only a few prostate cancers showing scattered (