The Expression Of AMACR And E-cadherin In Moderately And Poorly Differentiated Prostate Cancer And The Significance For Its Diagnosis And Prognosis

Prostate cancer(PCa) is the most common tumor of the urinary system and male genital organs. About percent forty-two of males over fifty years old in Europe and North America have perhaps prostate cancers. The mortality of PCa is the second of all kinds of male tumors. Approximate a half of old men have latent prostate cancers. And percent forty of clincal prostate cancers become advance tumors. Prognostic difference between the different individuals is remarkably. The incidence of our country and other countries in Asia has a increasing trend. The study about early diagnosis and prognosis for Prostate cancer is an important medical scientific reseach.The pathological diagnosis of biopsy specimens is the"Golden Standard"of diagnosis of PCa. But features of histology of high-grade prostatic Intraepithelial Neoplasia (HGPIN) and atipical adenomatous hyperplasia(AAH) are similar with PCa and the distinguishment between them is difficult. AMACR is extracted through microarray technology by Luo as a specific marker of PCa. It is not expressed in nomal prostatic tissue and Benign Prostatic Hyperplasia (BPH). The sencitivity of AMACR is 80%-100%. The specificity of AMACR is 79%-100% in a number of researchs. AMACR is a sensitive and specific highly marker.Objectives:We has studied the immunohistochemical expression of AMACR and E-cadherin in PCa and explored its corrrelation with diagnosis and prognosis.Method:1. Histologically pathological observation87 cases of PCa from Jilin University China-Japan Union Hospital and JiHua Hospital were diagnosed pathologically and classified histologically and Gleason-graded according to WHO classification (2004). 2. AMACR and E-cadherin immunohistochemical detection for PCa Sections were deparaffinized, washed and placed into EDTA(PH9.0)in a pressure cooker and heat-induced antigen retrieval and were labelled by rabbit moloclonal antibody AMACR(P504S)(ZYMED). Sections were deparaffinized, washed and placed into citrate (PH6.0) in a pressure cooker and heat-induced antigen retrieval and were labelled by mouse moloclonal antibody E-cadherin(ZYMED). Sections were placed in 3% H2O2 for 10 minutes. Sections were incubated in 4℃for one night. Sections were applied secondary antibody. Sections were visualized by DAB chromogen for a few minutes, rinsed, counterstained with hematoxylin for 30 seconds, dehydrated, and a coverslip was applied.Sections were viewed with microscopes and judged with results.3. Statistics processing and photograph The dates were applied by Statistics Microsoft SPSS13.0 andχ2 tests. Photograph the diagnosing Sections and the labelled Sections applying pathology image formation system DEIAS2000Results:1.Classification and grading for tumours.The average age of the 87 cases was 64.75 years old. Of them 59 were ASP specimens, 17 were TURP specimens, 11 were RP specimens. 77 cases were acinar adenocarcinomas (2 cases of mucinous adenocarcinomas), 6 cases were neuoroendocrine carcinomas . 4 cases were transitional cell carcinomas. All cases were Gleason grade≧ 5. 14 cases were Gleason grade 5-7. 62 cases were Gleason grade 8-10 . Of all the tumour specimens, 34 were with BPH, 24 were with BCH and 2 were with PIN.2.The expression of AMACR in moderately and poorly differentiated prostate cancer.66 specimens of moderately and poorly differentiated prostatic acinar adenocarcin- omas expressed AMACR. The positive rate is 85.71%. AMACR is negative in BPH and BCH tissue specimens. AMACR is positive in two specimens with PIN.The positive rate of AMACR in moderately differentiated prostatic acinar adenocarcinomas is 78.51%. The positive rate of AMACR in poorly differentiated prostatic acinar adenocarcinomas is 88.71%. The relationship between expression of AMACR in moderately and poorly differentiated prostatic acinar adenocarcinomas and its Gleason Score had no significant difference (χ2 =0.408, P=0.816).The positive rate of AMACR in neuoroendocrine carcinoma is 50%. The positive rate of AMACR in transitional cell carcinoma is 75%. The positive rate of AMACR in mucinous adenocarcinoma is 50%3. The expression of E-cadherin in moderately and poorly differentiated prostate cancer.E-cadherin was expressed normally in normal tissues and BPH. The positive rate of E-cadherin in moderately and poorly differentiated prostatic acinar adenocarcinomas was 28.77%. The positive rate of E-cadherin in specimens of GS 5-7 was 61.54%. The positive rate of E-cadherin in specimens of GS 8-10 was 21.67%. The relationship between expression of E-cadherin in moderately and poorly differentiated prostatic acinar adenocarcinomas and its Gleason Score had significant difference(χ2 =0.6458, P=0.011). The positive rate of E-cadherin in neuoroendocrine carcinoma was 16.67%. E-cadherin was all expressed aberrantly in 4 samples of transitional cell carcinoma and 2 samples of mucinous adenocarcinoma.Conclusions:AMACR is the specific biomarker of prostate cancer. The immunohistochemical labelling of AMACR offers important value for prostate cancer. The expression of AMACR in prostatic acinar adenocarcinomas and the extent of tumoral differention have no significant correlation. Aberrantion and loss of expression of E-cadherin in prostatic acinar adenocarcinomas predit the low extent of tumoral differention and high malignant characteristics. E-cadherin can become the preditor for prostatic acinar adenocarcinomas. E-cadherin was expressed lowly and in loss in neuoroendocrine carcinoma, transitional cell carcinoma and mucinous adenocarcinoma. So we conjecture that neuoroendocrine carcinoma, transitional cell carcinoma and mucinous adenocarcinoma are adhesive lowly, invasive highly and have poor prognosis. The relationship between expression of E-cadherin and the extent of tumoral differention will be expected to more deeply study in the future.