高级别前列腺上皮内瘤（HGPIN）的研究新进展

前列腺上皮内瘤（HGPIN）分为低级别上皮内瘤与高级别上皮内瘤,目前高级别前列腺上皮内瘤是公认的前列腺腺癌的癌前病变,在形态学、遗传学和分子生物学特点上和前列腺癌有许多相似之处。其病因仍不明,临床上影像学检查和实验室检查对其诊断帮助不大,其诊断主要依靠病理组织学检查,包括前列腺穿刺活检与手术切除的组织。免疫组织化学染色应用P504S、P63、34茁E12 有助于和前列腺癌相鉴别。而首次穿刺活检诊断为HGPIN 的患者应定期复查血PSA和定期行增加穿刺针数的活检,是否对HGPIN 行前列腺癌的治疗方法尚存在争议,本文对高级别前列腺上皮内瘤的研究进展做综述如下。     

高级别前列腺上皮内瘤(HGPIN)的研究新进展

前列腺上皮内瘤(HGPIN)分为低级别上皮内瘤与高级别上皮内瘤,目前高级别前列腺上皮内瘤是公认的前列腺腺癌的癌前病变,在形态学、遗传学和分子生物学特点上和前列腺癌有许多相似之处。其病因仍不明,临床上影像学检查和实验室检查对其诊断帮助不大,其诊断主要依靠病理组织学检查,包括前列腺穿刺活检与手术切除的组织。免疫组织化学染色应用P504S、P63、34βE12有助于和前列腺癌相鉴别。而首次穿刺活检诊断为HGPIN的患者应定期复查血PSA和定期行增加穿刺针数的活检,是否对HGPIN行前列腺癌的治疗方法尚存在争议,本文对高级别前列腺上皮内瘤的研究进展做综述如下。     

Cox-2、P504s、CK34βE12和P63在前列腺腺癌中的表达及其临床意义

目的：研究Cox-2、P504s、CK34βE12和P63在前列腺腺癌组织中的表达及其临床病理学意义。方法：用免疫组织化学法检测134例正常前列腺、良性前列腺增生和前列腺腺癌石蜡包埋组织中Cox-2、P504s、CK34βE12和P63的表达。结果：正常前列腺组织或良性前列腺增生组织未见或偶见P504s弱表达,但CK34βE12和P63均表达良好;前列腺腺癌组织中P504s表达良好,但CK34βE12和P63均表达消失,P504s表达阳性率为91．07％;与正常前列腺组和良性前列腺增生组相比,前列腺癌组的P504s阳性表达率存在显著性差异（p=0．001）。COX-2在正常的前列腺组织几乎不表达,而良性前列腺增生组织及前列腺腺癌组织均可见阳性表达,阳性率分别为4．76％和80．36％;COX．2阳性表达率在正常前列腺组或良性前列腺增生组和前列腺腺癌组间有显著性差异（p=0．0027）。COX-2与P504s表达存在相关性（r=0．377,P=0．039）;COX-2的表达与年龄、临床分期、分化程度、有无远处转移等临床病理特征间无明显相关关系。结论：联合P504s、P63、CK3413E12和COX-2免疫组化检测可提高前列腺腺癌病理诊断的准确率。     

紫杉醇抑制前列腺癌增殖的体内实验研究

目的探讨紫杉醇对人前列腺癌细胞PC-3增殖的体内抑制作用。方法建立体内绿色荧光蛋白（GFP）标记的人雄激素非依赖性前列腺癌细胞PC-3裸鼠原位移植瘤模型,观察紫杉醇对裸鼠前列腺癌原位移植瘤的体积、重量的影响。结果裸鼠模型体内实验显示,与对照组（100μL生理盐水）相比,紫杉醇处理组（0.5 mg/kg）在给药第18天后能显著抑制前列腺肿瘤的体积（P〈0.05）;紫杉醇处理组在抑制前列腺肿瘤重量方面与对照组相比亦有明显抑制作用（P〈0.05）。与对照组相比G31P处理组VEGF（P〈0.05）的表达差异具有统计学意义（免疫组化法）。结论紫杉醇在体内实验中能明显抑制人雄激素非依赖性前列腺癌细胞系PC-3的增殖。     

Cox-2、P504s、CK3413E12和P63在前列腺腺癌中的表达及其临床意义

目的:研究Cox-2、P504s、CK34βE12和P63在前列腺腺癌组织中的表达及其临床病理学意义.方法:用免疫组织化学法检测134例正常前列腺、良性前列腺增生和前列腺腺癌石蜡包埋组织中Cox-2、P504s、CK34βE12和P63的表达.结果:正常前列腺组织或良性前列腺增生组织未见或偶见P504s弱表达,但CK34βE12和P63均表达良好;前列腺腺癌组织中P504s表达良好,但CK34βE12和P63均表达消失,P504s表达阳性率为91.07%;与正常前列腺组和良性前列腺增生组相比.前列腺癌组的P504s阳性表达率存在显著性差异(p=0.001).COX-2在正常的前列腺组织几乎不表达,而良性前列腺增生组织及前列腺腺癌组织均可见阳性表达,阳性率分别为4.76%和80.36%;COX-2阳性表达率在正常前列腺组或良性前列腺增生组和前列腺腺癌组间有显著性差异(p=0.0027).COX-2与P504s表达存在相关性(r=0.377,P=0.039);COX-2的表达与年龄、临床分期、分化程度、有无远处转移等临床病理特征间无明显相关关系.结论:联合P504s、P63、CK34βE12和COX-2免疫组化检测可提高前列腺腺癌病理诊断的准确率.     

以前列腺干细胞抗原为靶点的前列腺癌免疫治疗研究进展

前列腺干细胞抗原(PSCA)为细胞膜表面抗原,在正常前列腺组织中低表达,在雄激素依赖性和非依赖性前列腺癌组织中高表达,有较高的组织特异性,是前列腺癌治疗的理想靶标,近年来以PSCA为靶点的前列腺癌治疗性疫苗的研究已成为热点。我们简要综述以PSCA为靶点治疗前列腺癌的研究进展。     

PSMA、CD44v6在前列腺癌组织中的表达及相关性研究

目的探讨PSMA、CD44v6在前列腺癌中的表达及其与临床特征的关系,为临床预测前列腺癌的转移潜能及预后、指导治疗提供客观有效的指标。方法采用免疫组化S-P法检测PSMA、CD44v6在前列腺癌、前列腺增生及正常前列腺组织中的表达情况。结果PSMA在前列腺癌组织与前列腺增生组织中的表达无显著性差异;肿瘤分化程度低及有淋巴结转移者PSMA表达明显高于分化程度高及无淋巴结转移者。CD44v6在正常前列腺组织及前列腺增生组织中无表达,在前列腺癌组织中的表达较高,并且分化程度低及有淋巴结转移者CD44v6表达明显高于分化程度高及无淋巴结转移者。结论前列腺癌组织中PSMA与CD44v6的表达与肿瘤分化程度、淋巴结转移有关,且两者的表达在前列腺癌组织中具有相关性。     

VEGF-C、FLt4和结核菌L型感染在前列腺癌中的表达及临床意义

目的探讨血管内皮细胞生长因子-C(VEGF-C)与血管内皮细胞生长因子受体VEGFR-3(Flt4),在前列腺癌中的表达以及结核菌L型感染率及临床意义。方法应用免疫组化和原位杂交和抗酸染色等方法检测65例前列腺癌(carcinoma of prostate,PCa)和30例良性前列腺增生(benign prostatic hyperplasia,BPH)中的VEGF-C、Fit4蛋白及mRNA的表达,以及结核菌L型的检出率。并对前列腺肿瘤主要临床资料和病理分级参数进行比较,用χ2检验进行统计学处理。结果VEGF-C、Flt4蛋白及mRNA阳性表达率和结核菌L型检出率,前列腺癌明显高于前列腺增生(P0.001~0.05)。VEGF-C、Flt4蛋白及mRNA阳性表达率和结核菌L型检出率与前列腺癌的临床分期、病理分级有明显差异(P0.05)。淋巴结转移组中VEGF-C、Flt4蛋白及mRNA的阳性表达率明显高于非转移组(P0.01)。结核菌L型检出率淋巴结转移组明显高于非转移组(P0.05)。结论VEGF-C、Flt4的蛋白及mRNA在前列腺肿瘤中不同程度异常表达以及结核菌L型检出率与肿瘤的临床分期、病理分级和转移呈正相关,提示这2种基因均可作为判断前列腺癌生物学行为及患者预后参考指标;结核菌L型感染可能有协同致瘤作用,与前列腺癌的发生发展可能有一定关系。因此研究VEGF-C、Flt4的阳性表达和结核菌L型感染与前列腺癌的关系,具有重要的临床应用价值。     

VEGF、KDR和结核菌L型感染在前列腺癌中的表达及临床意义

目的 探讨血管内皮生长因子(VEGF)及其受体VEGFR-2(KDR)和结核菌L型感染在前列腺肿瘤中的表达及临床相关性研究.方法 应用免疫组化、原位杂交和抗酸染色等方法检测了65例前列腺癌(carcinoma of prostate,PCa)和30例良性前列腺增生(benign prostatic hyperplasia,BPH)中的VEGF、KDR蛋白及mRNA的表达,以及结核菌L型的检出率.并对前列腺肿瘤主要临床资料和病理分级参数进行比较,用χ2检验进行统计学处理.结果 VEGF、KDR蛋白及mRNA阳性表达和结核菌L型检出率前列腺癌明显高于前列腺增生(P<0.001～0.05).VEGF、KDR蛋白及mRNA阳性表达以及结核菌L型检出阳性率与前列腺癌的临床分期、病理分级差异有显著性(P<0.01～0.05).结论 VEGF及KDR蛋白及mRNA在前列腺肿瘤中有不同程度的异常表达,可能与结核菌L型感染有协同致瘤作用.提示2种基因均可作为判断前列腺癌生物学行为及患者预后参考指标.结核菌L型感染可能与前列腺癌的发生发展可能有一定关系,因此研究结核菌L型感染与前列腺癌的关系,具有重要的临床应用价值.     

磁共振成像联合血清前列腺特异抗原、上皮钙黏蛋白、早期前列腺癌抗原-2诊断前列腺癌的临床价值探讨

摘要 目的：探究磁共振成像（MRI）联合血清前列腺特异抗原（PSA）、上皮钙黏蛋白（sE-cadherin）、早期前列腺癌抗原-2（EPCA-2）诊断前列腺癌的临床价值。方法：选取潍坊市人民医院2020年1月-2021年7月期间经病理证实的50例前列腺癌患者（前列腺组）以及50例前列腺增生患者（前列腺增生组）展开回顾性研究。100例研究对象均完善了MRI检查并测定血清PSA、EPCA-2、sE-cadherin水平,分析两组患者的MRI影像学特征,比较两组患者的PSA、EPCA-2、sE-cadherin水平以及各项检查方法的诊断准确性差异。结果：前列腺癌的MRI影像学特征为病灶主要位于外周带,外周带T2W呈低信号,病变侵及包膜、膀胱及周围组织具有T1加权消失或者不对称,具有信号异常、肌肉增厚的表现,盆腔淋巴结转移具有淋巴结部分融合或增大表现;前列腺增生的MRI影像学特征为边界清晰、包膜完整并且中央带增生、不均匀信号结节;前列腺癌、前列腺增生均存在不同程度的前列腺体积增大。相比于前列腺增生组,前列腺癌组患者的PSA、sE-cadherin、EPCA-2水平明显更高（P<0.05）。MRI、PSA、sE-cadherin、EPCA-2四项联合鉴别前列腺癌、前列腺增生的诊断符合率为96.00%,明显高于四项单独诊断的88.00%、79%、81%、82%（P<0.05）。结论：MRI联合PSA、sE-cadherin、EPCA-2鉴别诊断前列腺癌的准确性较高,具有作为临床前列腺癌早期诊断指导方案的潜力。     

Arguments against the prostatic origin of the R-3327 Dunning H tumor

The Dunning tumor, originally described as a carcinoma of the rat dorsal prostate, has for long been used as an experimental model of prostatic cancer. We have recently presented a number of morphological findings that are incompatible with the prostatic origin of the H-subline of the Dunning tumor. In this paper, biochemical and immunohistochemical markers of rat prostate and mammary gland are studied in the R-3327 Dunning H tumor. Pieces of the H tumor were inoculated in male or lactating female rats. The electrophoretic protein pattern of Dunning tumor extracts was more similar to that of the mammary gland than the dorsolateral prostate. Proteins selectively appearing after metabolic labeling in Dunning tumors grown in lactating rats corresponded to labeled proteins in mammary glands from the same animals. Secretory proteins typical of the lateral prostate (SVS II) and dorsal prostate (transglutaminase) could not be detected immunohistochemically in the Dunning tumor. Western blot studies of tumor extracts and slot blot analysis of RNA preparations from the tumor confirmed the absence of SVS II and prostate specific transglutaminase from the Dunning tumor. On the other hand, the presence of mammary gland proteins such as milk fat globule membrane proteins, lactoperoxidase and lactalbumin were detected in the Dunning tumor by immunohistochemistry and Western blotting, but were absent from the dorsolateral prostate. Transferrin-mRNA, expressed in the male urogenital tract and also in the liver and other tissues, was detected in the mammary gland and Dunning tumor, but not in the dorsolateral prostate. The absence of mammary gland secretory beta-casein in the Dunning tumor was related to the elevated Ha-ras oncogene expression in the tumor, previously reported to suppress casein expression. The findings clearly demonstrate that the prostate cannot be the origin of the Dunning tumor, presently being used in prostatic cancer research. The designation prostatic adenocarcinoma for this tumor is therefore invalid. Furthermore, the data support our view that mammary gland might be the origin of the Dunning tumor, although the derivation from the bulbourethral or the parotid glands cannot strictly be excluded.     

Fine needle aspiration biopsy of intraparotid schwannoma. A case report

BACKGROUND: Intraparotid schwannoma of the salivary gland is a rare entity. Review of the literature revealed one previous report describing its cytologic features. CASE: A 22-year-old man had a slowly growing, painless mass in the left parotid gland. Fine needle aspiration biopsy, performed prior to surgical excision, showed several tissue fragments consisting of uniform, spindle-shaped neoplastic cells with cigar-shaped nuclei and scant, ill-defined cytoplasm. Some of the neoplastic cells were clustered in typical arrangements of Verocay bodies. In addition, lymphocytes and foamy histiocytes were found. A diagnosis of schwannoma was made. Pathologic evaluation of the resected parotid mass supported the diagnosis. CONCLUSION: The diagnosis of intraparotid schwannoma can be made by examining cytologic material containing the characteristic Verocay bodies. The correct cytologic diagnosis of this entity helps to rule out morphologically similar primary salivary gland neoplasms and thereby permits the appropriate surgical procedure to ensue.     

Basal cells of H-Dunning tumor are myoepithelial cells. A comparative immunohistochemical and ultrastructural study with male accessory sex glands and mammary gland

Recent immunohistochemical studies have shown that basal cells in human prostatic epithelium are not myoepithelial cells. Since in the literature the Dunning tumor, originally described as a rat prostate carcinoma derived from the dorsolateral prostate of a Copenhagen rat, was reported to have myoepithelial cells, a comparative immunohistochemical and ultrastructural study was performed in the H-, HIF- and AT3-lines of the Dunning tumor, the male accessory sex glands (ventral, dorsal, lateral prostate, coagulating gland, bulbourethral gland) and the mammary gland of both Copenhagen and Wistar rats. Mono- and polyclonal antibodies directed against intermediate filament proteins (cytokeratin, desmin, vimentin) and the contractile proteins (alpha-actin, muscle type specific myosin, tropomyosin) were used along with phalloidin decoration of F-actin. As in the human prostate, none of the rat prostate lobes in either strains did contain basal cells expressing cytokeratin along with alpha-actin, myosin and tropomyosin Cells representing fully differentiated myoepithelial cells, however, were present as anticipated in the mammary gland, the bulbourethral gland and the H-tumor line of the Dunning tumor. This finding is difficult to reconcile with the contention of a prostatic origin of the H-Dunning tumor. Further studies are required to classify the epithelial parental tissue in order to define the true origin of the H-Dunning tumor and the tumor lines derived thereof.     

Fine needle aspiration biopsy of cystic benign lymphoepithelial lesion of the parotid gland in patients at risk for the acquired immune deficiency syndrome

Cystic benign lymphoepithelial lesion (BLL), a previously rare lesion of the parotid gland consisting of marked lymphoid hyperplasia with accompanying squamous-lined cysts, has recently been described in patients with the acquired immune deficiency syndrome (AIDS) or AIDS risk factors. Thirteen fine needle aspiration (FNA) samples of parotid gland masses from patients with AIDS (one case), AIDS risk factors (five cases) or denial of AIDS risk factors (two cases) and a histopathologic diagnosis of BLL were examined. The FNA features that correlated best with the histopathologic findings were (1) a heterogeneous lymphoid population, (2) scattered single and/or clustered foamy macrophages and (3) superficial and/or anucleated squamous cells. Most aspirates showed some combination of these three components. The differential diagnostic considerations, the clinical and radiologic correlations and the relationship of this lesion to HIV infection are discussed. Patients with parotid masses whose aspirates consist of some combination of squamous cells, lymphocytes and foamy macrophages should be questioned for possible AIDS risk factors.     

Inflammatory malignant fibrous histiocytoma of the retroperitoneum

The authors present a case of inflammatory malignant fibrous histiocytoma located in the left retroperitoneum. The tumor was resected enblock with kidney and suprarenal gland. During the resection the system of retractors called the pillars of Kocman was used which allowed wide exposure of the abdominal cavity. The tumor measured 23 x 17 x 10 cm with the left kidney and suprarenal incorporated. The tumor was centrally pseudocystic made of xanthomatous cells, foamy cells and rare giant cells with storiform formations and infiltrated with neutrophils. Imunohistochemically, the tumor cells were vimentin and CD 68 positive and CD 20, CD3, EMA, S-100, HMB 45, CD 34 and CD 1a negative. Neutrophils were CD 15 positive.     

Architectural, morphometric and photometric features and their relationship to the main subjective diagnostic clues in the grading of prostatic cancer

Novel software was developed to perform quantitative measurements of architectural and nuclear features in tissue sections. A pilot study was then undertaken to determine the diagnostic relevance of these quantitative features in prostatic tissue and the relationship of these objective features to the subjective clues used by practicing pathologists in the grading of prostatic adenocarcinoma. From a group of 82 cases of adenocarcinoma of the prostate with long-term follow-up, a subset of 15 cases that included 5 each in Mostofi grades I, II and III was carefully selected for analysis. Consecutive sections from each case were stained with hematoxylin and eosin or the Feulgen stain for visual and cytometric evaluations, respectively. The most important differences in the objective architectural features observed between the Mostofi grade I and II cases were the number of nuclei per gland and their distance from the glandular center. Significant differences were also noted in gland size and the variation in gland size. The Mostofi grades were also significantly different in terms of quantitative high-resolution features measuring nuclear size and its variation, total nuclear DNA content and the proportion of very aneuploid nuclei. There was a fairly good agreement between many of the subjective diagnostic clues and their corresponding quantitative architectural and nuclear features. This work (1) significantly extended the capabilities of our PC-based microphotometer system to analyze glandular tissue specimens, (2) provided insight into the objective bases for the expert diagnosis of adenocarcinomas of the prostate and (3) gave preliminary evidence of the ability of quantitative architectural features and high-resolution cytometric features to discriminate between the major diagnostic categories of these lesions.     

Canine prostatic disease: a review of anatomy, pathology, diagnosis, and treatment

Disease conditions affecting the canine prostate gland are encountered frequently in small animal practice. The most common conditions affecting the canine prostate include benign prostatic hyperplasia, prostatitis, prostatic cysts, and prostatic neoplasia. Clinical signs associated with each of these conditions often overlap; therefore, it is important to reach a definitive diagnosis prior to initiating treatment. This paper reviews the diseases associated with the prostate gland of the dog, their diagnosis, as well as current treatment options for management of these conditions. Emphasis is placed on proper diagnostic sampling of the prostate gland, its fluid, and interpretation of findings, as well as emerging medical options for treatment of canine prostatic disease.     

Basal cells of H-Dunning tumor are myoepithelial cells

Summary Recent immunohistochemical studies have shown that basal cells in human prostatic epithelium are not myoepithelial cells. Since in the literature the Dunning tumor, originally described as a rat prostate carcinoma derived from the dorsolateral prostate of a Copenhagen rat, was reported to have myoepithelial cells, a comparative immunohistochemical and ultrastructural study was performed in the H-, HIF- and AT₃-lines of the Dunning tumor, the male accessory sex glands (ventral, dorsal, lateral prostate, coagulating gland, bulbourethral gland) and the mammary gland of both Copenhagen and Wistar rats. Mono- and polyclonal antibodies directed against intermediate filament proteins (cytokeratin, desmin, vimentin) and the contractile proteins (-actin, muscle type specific myosin, tropomyosin) were used along with phalloidin decoration of F-actin. As in the human prostate, none of the rat prostate lobes in either strain did contain basal cells expressing cytokeratin along with -actin, myosin and tropomyosin. Cells representing fully differentiated myoepithelial cells, however, were present as anticipated in the mammary gland, the bulbourethral gland and the H-tumor line of the Dunning tumor. This finding is difficult to reconcile with the contention of a prostatic origin of the H-Dunning tumor. Further studies are required to classify the epithelial parental tissue in order to define the true origin of the H-Dunning tumor and the tumor lines derived thereof.     

Uterine müllerian adenosarcoma with histiocytic (xanthomatous) mesenchymal component.

We present an endometrial Müllerian adenosarcoma in which the sarcomatous component showed prominent nests of foamy cells that accounted for 50% of the neoplastic mesenchyma. Such foamy cells showed occasional cytological atypias and immunohistochemical features of histiocytic (macrophagic differentiation in the absence of changes that could substantiate the presence of an inflammatory infiltration of foamy histiocytes. These facts suggest histiocytic differentiation from neoplastic mesenchymal cells. Such differentiation has been reported in association with malignant mixed mesodermal tumor, but not in Müllerian adenosarcoma.     

Comparative morphometric analysis of thyrocytes in a primary tumor and regional metastases in papillary thyroid gland cancer

OBJECTIVE: To perform a comparative analysis of thyrocyte nuclei and the aggregability degree in tumor cells in the thyroid gland with papillary cancer and in cervical lymph nodes with metastases. STUDY DESIGN: Thyrocytes in papillary cancer and those of cervical lymph nodes with its metastasis have been studied with the help of morphometry. RESULTS: As a result of mathematical transformation of the initial morphometric database, quantitative features of thyrocyte nuclei and aggregates characterizing the norm, papillary cancer and regional metastases were obtained. These features were united into 2 systems of decision criteria on the base of a set of quantitative features of thyrocyte nuclei and aggregates. Analysis was performed among the groups of comparison with the help of these systems. CONCLUSION: Malignant cells of the primary tumor have been shown to have evident quantitative features of nuclear atypia and a higher degree of aggregability compared with the norm. The differences between the quantitative features of nuclei and aggregates in malignant cells of the primary tumor in the thyroid gland and its metastases in cervical lymph nodes were less pronounced.