摘要
目的对照研究高频超声在前列腺穿刺的引导作用及发现微小病灶的作用,探讨P3、ki67、nm23等抗体在前列腺癌、高级别前列腺上皮内瘤变及良性前列腺增生组织中的表达及意义,判断肿瘤的预后。方法在直肠经彩色多普勒超声仪(高频)及穿刺导向器引导下,用美国BARD公司的18G组织切割针及配套第三代自动弹射式活检枪,经会阴穿刺,对前列腺左右叶各5点共10点标准穿刺,活检标本石蜡包埋,制作蜡块连续切片,进行HE染色,并做P3(即P504s/P63/HMW CK)联合ki67、nm23免疫组化检测,观察在前列腺穿刺活检中的作用。结果 P3结合ki67、nm23在前列腺癌、高级别前列腺上皮内瘤变及良性前列腺增生组织中的阳性表达差异有统计学意义。经会阴穿刺与经直肠穿刺相比较,减少感染的发生。结论经会阴前列腺10点标准穿刺法,结合临床和影像学资料,鸡尾酒抗体,可以得到较高的确诊率;高频超声可以发现微小病灶;ki67、nm23可用于前列腺良恶性疾病的诊断、鉴别诊断与预后判断。
Objective To investigate the guidance and the ability to find mini-lesion of high-frequency ultrasound in prostate needle biopsy,and to explore the expression of P3 and ki67/nm in prostate adenocarcinoma（PAC）,high grade prostatic intraepithelial neoplasia（High Grade PIN） and benign prostatic hyperplasia（BPH） in order to assess the clinical and prognostic significance.Methods Standardized prostate biopsy through perineum were performed by the guidance of CDFI（high frequency） in rectum with 18G tissue needle and automatic biopsy gun,and routine HE section and immunochemical staining of P3（P504s/P63/HMW CK） plus ki67/nm23 were carried out.Results The statistic significance was demonstrated on expression of P3 plus ki67/nm23 positive staining among PAC,high grade PIN and BPH,and needle biopsy through perineum rather than through rectum may decrease the risk of infection.Conclusion With enough clinical information and radiological data,more and accurate diagnosis may be obtained by standardized prostate biopsy through perineum and cocktail immunochemical staining.The high frequency ultrasound can be helpful to detect small focal lesions and Ki67/nm23 may be useful in the diagnosis,differential diagnosis and prognosis evaluation in prostate benign and malignant diseases.
出处
《中华全科医学》
2011年第6期877-879,F0003,共4页
Chinese Journal of General Practice
