Abstract / Summary
Background: To explore the value and significance of tripleimmunohistochemical detection of alpha-methylacyl-CoAracemase (AMACR), p63 and Ki-67 in the pathologicaldiagnosis of prostate cancer.
Methods: A total of 156 paraffin-archived prostate biopsysamples collected from our hospital from June 2023 toAugust 2024 were selected as research materials. Theexpression levels of AMACR, p63 and Ki-67 in puncturesamples from 48 patients with prostate cancer, 32 patientswith high-grade prostate intraepithelial neoplasia, 26patients with low-grade prostate intraepithelial neoplasiaand 50 patients with benign prostatic hyperplasia weredetected via immunohistochemistry.
Results: There were statistically significant differences in thepositive expression rates of AMACR, p63 and Ki-67 amongthe different groups of samples. The positive expression rateof AMACR in the puncture samples of the prostate cancergroup was 100%, with a high expression rate of 81.25%. The negative expression rate of p63 was 97.92%, whichwas significantly greater than that of the other three groups.The positive expression rate of Ki-67 was 81.25%, and thehigh expression rate was 54.17%. The AMACR is related tothe long diameter of the tumour, TNM stage, degree of differentiation and Gleason score in patients with prostate cancer. The rates of high AMACR in patients with tumours withlong diameters S1.5 cm, stage II-III, moderate to highly differentiated, and Gleason scores ranging from 8-10 weresignificantly higher than those in patients with long diameters <1.5 cm, stage I. The expression of Ki-67 is related tothe long diameter of the tumour, degree of differentiation,degree of lymph node metastasis and Gleason score inpatients with prostate cancer. The rates of high expressionof Ki-67 in patients with a long tumor diameter of S1.5 cm,moderate and high differentiation, and lymph node metastasis and a Gleason score of 8-10 were significantly greaterthan those in patients with a long tumor diameter of <1.5cm, poor differentiation, no lymph node metastasis, and aGleason score of 2-7. p63 was not related to the clinical orpathological characteristics of patients with prostate cancer(all P>0.05). The sensitivity and negative predictive value ofthe combined diagnosis of AMACR-positive/p63-negative/Ki-67-positive prostate cancer were both 100.00%,and the specificity was 81.82%.
Conclusions: AMACR, p63 and Ki-67 in prostate biopsysamples can be used as promising biomarkers for the diagnosis or exclusion of prostate cancer. Combined detectioncan improve the accuracy of prostate cancer diagnosis.