The Value Of PSA,PAP,HCK,P63 And AMACR Immunostaining For The Diagnosis Of Benign And Malignant Lesions Of Prostate

ObjectiveAnalyze the value of PSA,PAP,HCK,P63 and AMACR immunostaining for the diagnosis of benign and malignant lesions of prostateMethodsAll the samples,121 cases of prostrate specimens, including 63 prostate cancer,30 BPH,17IGPIN,4 HGPIN,6 AAH, were confirmed by histomorphology and measured for PSA,PAP,HCK,P63 and AMACR by immunohistochemistry.Logistic regression,χ2 tests and nonparametric tests were used to analyze the value of PSA,PAP,HCK,P63 and AMACR immunostaining for the diagnosis of benign and malignant lesions and the relationship to Gleason.Results1,Logistic model can accuratetly separate malignant from benign prostate lesions Variable selection basic on a set of 3 variables for the models:HCK,P63,P504S.2,Both PSA and PAP show high sensitivities for prostate lesions, 91.7%(111/121).94.2%(114/121), respectively.There is no significant difference between the expression of PSA and PAP in all cases (P>0.05)3,Both HCK and P63 show high level sensitivities in 3 groups of benign lesions groups and low level sensitivities in prostate cancer group.When we evaluated the correlation of basal cell markers.We did not find any complementary staining results among basal cell markers.Both HCK and P63 are basal cell-specific marker, but HCK is more sensitive and specific.4,AMACR show high level expression in prostate cancer group and low level expression in bening lesions groups.5,AMACR shows false positive in benign prostate lesions and basal cell-specific markers show fales negative in prostate cancer;The application of AMACR combined with the first basal cell-specific marker—HCK may be of greater benefit in diagnosis of prostate cancer, a positive resule for P504S can assist the diagnosis of prostate cancer, while a staining for HCK and P63 may help to eliminate cancerous changes of a prostate.6,All prostate cancer cases enrolled into three groups depend on Gleason score.The first group 5-6 scores, the second group 7 scores, the third group 8-10 scores.The expression of PSA, PAP, HCK, P63 and AMACR were not correlated with degrees of Gleason scroe. Conclusions1,We suggest that HCK should be the first choice as a basal cell marker.P63 can be used together with HCK, but it may not give additional diagnostic information.Our study showed that HCK is a appropriate negative marker to combine with AMACR as a positive marker for the diagnosis of prostate adenocarcinoma, AMACR+HCK should be as routine markers.2,We did not recommend PSA and PAP as routine markers3,The expression of PSA,PAP,HCK,P63 and AMACR were not correlated with degrees of Gleason score,so the expression of these markers have not the guiding significance for establishment of the therapeutic principles of the prostate cancer patients, and are not helpful in the evaluation of prognosis...