Utility of p63 and AMACR in Differentiating Benign and Malignant Prostatic Lesions
DOI:
https://doi.org/10.21276/apalm.2744Keywords:
Adenocarcinoma, AMACR, Benign, Prostate, p63Abstract
Background: Prostate cancer is the sixth most common cancer in the world. Since treatment options and prognosis of prostatic adenocarcinomas and benign lesions differ significantly, so, the current study using p63and AMACR was carried out with aim to evaluate the utility of immunohistochemistry in resolving ambiguous lesions of prostate.
Methods: The study was conducted on 130 prostatic specimens which included prostate biopsy, TURP and prostatectomy specimens. Routine hematoxylin and eosin staining and immunohistochemical staining using AMACR, p63 monoclonal antibody marker were performed.
Results: Total of 130 cases of prostate samples were studied out of which benign lesions were seen in 102 cases (78.5%) and malignant carcinoma in 28 cases (21.5%). This study showed p63 had a sensitivity of 92.86% and specificity of 100% whereas AMACR has a sensitivity of 96.4% and specificity of 95%. BPH with prostatitis was a common finding in majority of benign lesions. All cases of LGPIN 15 cases (11.5%) were histologically associated with BPH, showing complete positivity in 12 cases (80%) and partial positivity in 3 cases (20%) with p63 immunostaining. HGPIN (1.5%) were associated with prostatic adenocarcinoma showing focal positivity whereas adenocarcinoma showed complete negativity of p63 expression (100%) and positive cytoplasmic staining with AMACR. Comparative study done between DRE, PSA, final histopathological diagnosis, expression of p63 and AMACR immunostaining gives highly significant p value of 0.001(<0.05).
Conclusion: p63 and AMACR are reliable markers which can be used in morphologically difficult cases.
References
Eble JN, Sauter G, Epstein JI, Sesterhenn IA. Pathology and genetics of tumours of the urinary system and male genital organs. Lyon: IARC Press; 2004. p.162-92.
Obiorah CC, Nwosu SO. A histopathological study of carcinoma of the prostate in Port Harcourt, Nigeria. Niger J Clin Pract 2011; 14(3):363-7.
Templeton H. Prostate cancer- presentation, diagnosis and treatment: what does the literature say? Int J Urol Nurs. 2007; 1(1):6-17.
Humphery PA. Diagnosis of adenocarcinoma in prostate needle biopsy tissue. J Clin Pathol. 2007; 60:35-42.
Sringley JR. Benign mimickers of prostatic adenocarcinoma. Mod Pathol. 2004; 17:328-48.
Gunia S, Koch S, May M, Dietel M, Erbersdobler A. Expression of prostatic acid phosphatase (PSAP) in transurethral resection specimens of the prostate is predictive of histopathologic tumour stage in subsequent radical prostatectomies. Virchows Arch 2009; 454(5):573-9.
Singh V, Manu V, Malik A, Dutta V, Mani NS, Patrikar S. Diagnostic utility of p63 and α-methyl acyl CoA racemase in resolving suspicious foci in prostatic needle biopsy and transurethral resection of prostate specimens. J Cancer Res Ther. 2014; 10(3):686-92.
Hsing AW, Chokkalingram AP. Prostate cancer epidemiology. Front Biosci 2006; 11(2):1388-413.
Shapiro E, Becich MJ, Hartanto V. The relative proportion of stromal and epithelial hyperplasia is related to development of symptomatic benign prostate hyperplasia. J Urol.1992; 147:1293-1296.
Sharma A, Sharma M, Gandhi S, Khajuria A, Goswami KS. Int J Res Med Sci. 2017;5(6):2373-2378.
Thaker BD, Raina S, Singh K. Histopathological spectrum of prostatic lesion: a hospital based study.GJRA. 2017;6(7).
Puttaswamy K, Prathibhan R, Shariff S. Histopathological study of prostatic biopsies in men with prostatism. J Med. Sci. Health,2016;2(1):11-17.
Kumar M, Khatri SL, Saxena V,Vijay S. Clinicopathological study of prostatic lesions. IJBAMR. 2016; 6:695-704.
Khatib W, Jagtap S, Demde R, Shukla DB, Bisht T. Clinicopathological study of prostate lesions-A one year study. Int J Med Res Health Sci. 2016,5(5):183-186.
Chandanwale S, Jadhav SP, Anwekar CS, Kumar H, Buch CA, Chaudhari SU. Clinicopathological Study of Benign & Malignant Lesions of Prostate. IJPBS. 2013;3(1):162-178.
Garg M, Kaur G, Malhotra V, Garg R. Histomorphological spectrum of 364 prostatic specimens including immunohistochemistry with special reference to grey zone lesions. Prostate Int. 2013;1(4):146-151.
Anushree C.N., Venkatesh Kusuma. Morphological Spectrum of Prostatic Lesions- A Clinicopathological Study. Medica Innovatica 2012; 1(2): 49-54.
Schmitz M. American cancer society prostate cancer screening guidelines. About, com, Updated January 21,2010.
Bai EL, Sandhya S, Annapurna P, Rani HS. A Histomorphological Study of Prostatic TURP Specimens with Special Reference to Prostatic Intraepithelial Neoplasia by Using Immunohistochemistry. IJAR. 2018;6.
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