前立腺腫瘍の組織化学的研究

Abstract

1980年1月より1983年12月までに, 名古屋大学病院他を受診した患者の内, 正常前立腺8例, 肥大症27例, 前立腺癌40例の組織を, 前立腺肥大症と前立腺癌組織との組織化学的相異を明らかにする目的で, 1% CPC-10%ホルマリン液にて固定し, パラフィン切片として, 複合糖質染色, タンパク検出用染色, PAP検出用染色, 血中のPAP値測定等を行なった.癌間質には硫酸ムコ多糖, 特にコンドロイチン硫酸A, C, 及び弱酸性ムコ多糖, とりわけヒアルロン酸が存在した.癌細胞にも同様に, 硫酸ムコ糖, 弱酸性ムコ多糖, ヒアルロン酸, シアル酸が存在した.間質には硫酸ムコ糖がより多く, 細胞には弱酸性ムコ多糖がより多く存在した.前立腺肥大症の間質には, コンドロイチン硫酸Bや弱酸性ムコ多糖ことにヒアルロン酸が少量存在した.前立腺肥大症の腺上皮細胞には, 硫酸ムコ多糖は認められず, 弱酸性ムコ多糖ことにヒアルロン酸が存在した.正常前立腺も, ほゞ同様の結果であった.正常前立腺, 肥大症の基底膜にはコンドロイチン硫酸B, ヒアルロン酸等が存在したが癌組織で, 低分化型程, 基底膜は明らかではなかった.癌間質には正常前立腺, 肥大症に比較して1, 2-glycol基を持つ糖タンパクは減少していた.癌細胞中のβ-D-galactose残基を含む糖タンパクの分布には各症例間で差があり, PO-RCA-DAB染色の染色性により三大別が可能であり, この染色性と臨床経過との間に相関が認められた.癌細胞中のα-D-glucose, α-D-mannose残基を含む糖タンパクの分布には各症例間で差があり, Con A-PO-DAB染色の染色性により三大別が可能であり, Con A-PO-DAB染色性と, 血中の前立腺性酸フォスファターゼ値との間に相関がみられた.正常前立腺と肥大症の前立腺性酸フォスファターゼは細胞内で極性を示した.癌細胞中の前立腺性酸フォスファターゼは極性を失なっていたが肥大症とほゞ同様に染色された.血中の前立腺性酸フォスファターゼ値と癌細胞内の前立腺性酸フォスファターゼの染色性とは必ずしも相関しなかった.以上の結果より前立腺肥大症と癌組織における, 複合糖質の組織化学的相異や, 癌の分化度等による複合糖質の分布の差が示され, これらは, 合わせて臨床面への応用が可能である事が示された

Seventy five prostatic specimens from cancer, BPH and normal controls were studied by light microscopic histochemical methods for the demonstration of complex carbohydrates and some proteins: 1) alcian blue (AB) (pH 1.0), 2) alcian blue (AB) (pH 2.5), 3) Periodic Acid-Schiff (PAS), 4) peroxidase labelled-Ricinus communis agglutinin-diaminobenzidine (PO-RCA-DAB), 5) Concanavalin A-peroxidase-diaminobenzidine (ConA-PO-DAB), 6) ConA-PO-DAB-periodic acid-m-aminophenol Fast black salt K (ConA-PO-DAB-PA-AP-FBK). For identifying individual acidic and neutral carbohydrates, following procedures of enzyme digestion were performed upon some tissue sections prior to the above histochemical staining: a) sialidase (prior to staining with AB at pH 2.5), b) streptomyces hyaluronidase (prior to staining with AB at pH 2.5), c) testicular hyaluronidase (prior to staining with AB at pH 1.0 or pH 2.5), d) chondroitinase ABC (prior to staining with AB at pH 1.0 or pH 2.5), e) chondroitinase AC (prior to staining with AB at pH 1.0 or pH 2.5), f) alpha-amylase (prior to staining with PAS). In addition, the tissue specimens from prostatic cancer were stained immunohistochemically for demonstration of prostatic acid phosphatase (PAP) and the serum PAP levels were also measured by radioimmunoassay. The histochemical differences in the prostatic tissue among normal control, BPH and cancer as follows. In the tissue of prostatic cancer, chondroitin sulfate A, C and hyaluronic acid were present in the interstitium. Chondroitin sulfate, hyaluronic acid and sialic acid were present in the cytoplasm of cancer cells. In the tissue of BPH chondroitin sulfate B and hyaluronic acid was present in the interstitium and hyaluronic acid was present in the cytoplasm of epitherial cells. In the epithelial basement membrane of the tissue from BPH, chondroitin B and hyaluronic acid were present. 1, 2-Glycol groups of neutral complex carbohydrates in the interstitium of prostatic cancer were shown to exist in smaller amounts than in that of BPH. In the cytoplasm of cancer cells the intensity of both PO-RCA-DAB and ConA-PO-DAB staining could be divided into three groups: strong, moderate and weak. In the prostatic cancer there was a good correlation between the intensity of PO-RCA-DAB staining and tumor grade, and intensity of ConA-PO-DAB staining was correlated well with serum PAP level. The cytoplasm of cancer cells showed a positive reaction to PAP immunostaining and no appreciable difference was observed according to tumor grade.(ABSTRACT TRUNCATED AT 400 WORDS)