Peculiarities of immunohistochemical differential diagnosis of benign prostatic hyperplasia, intraepithelial neoplasia and prostate cancer.
DOI:
https://doi.org/10.26641/1997-9665.2016.3.297-301Keywords:
prostate neoplasms, prostatic intraepithelial neoplasia, high molecular weight cytokeratin, AMACR/p504s, receptors androgenAbstract
Background. According to global statistics prostate cancer (РС) is the second leading cause of death and takes the second place in males cancer structure. Objective. Trephine biopsies of 32 patients with acinar РС and 30 patients with benign prostatic hyperplasia (BPH), which in 22 patients were combined with multifocal prostatic intraepithelial neoplasia (PIN) were studied. Methods. Immunohistochemical method was used to determine the expression of high molecular weight cytokeratin (CK HMW), alpha-methylacetyl-CoA racemase (AMACR/p504s) and androgen receptors. Results. Immunohistochemical differential feature of BPH is the presence in basal glands CK HMW-positive cells and lack of cytoplasmic expression of AMACR/p504s in secretory gland cells. Tufting, micropapillary and cribriform high-grade PIN differs from acinar PC by the presence of basal CK HMW-positive cells in the proliferative atypical epithelial-luminal cells and the absence in the last one of cytoplasmic expression of AMACR/p504s. Acinar PC is characterized by the absence of basal NMW CK-positive tumor cells in the cancer acini, cytoplasmic expression of AMACR/ p504s in malignant epithelial cells. Nuclear expression of androgen receptors are defined in the epithelium cells of acini and fibromuscular stroma of prostate, as well as in malignant PC acinar cells. Conclusion. The absence in acinar structures of CK HMW-positive basal cells and presence of AMACR/p504s-positive tumor cells in trephine biopsy of prostate give the possibility to authentically determine acinar PC and differentiate it from high-grade PIN and from different subtypes of BPH.
References
- Lopatkin NA., author. [Urology: National guidelines]. Moscow: GEOTAR-Media; 2009. 1024 p. Russian.
- Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136(5):359- 86.
- American Cancer Society. Cancer Cancer Facts & Figures 2016. Atlanta: American Cancer Society; 2016. 66 р.
- Fedorenko ZP, Hulak LO, Mykhailovych YuI, Horokh YeL, Ryzhov AIu, Sumkina OV, Kutsenko LB, authors; Kolesnik OO, editor. [Bulletin of the National Cancer register No.17 “Cancer in Ukraine, 2014-2015”]. Kyiv: National cancer insti-tute; 2016. 163 p. Ukrainian.
- Pushkar DYu, Govorov AV [Biopsy of prostate]. Moscow: GEOTAR-Media. 2010. 208 p. Russian.
- Ro JY, Kim K-R, Shen SS, Amin MB, Ayala AG, authors; Fletcher CDM, editor. Diagnostic Histopathology of Tumors. 4Ed. Philadelphia: ELSEVIER Saunders; 2013. 872-950 p.
- Kristiansen G, Epstein JI, authors. Imunohistochemistry in Prostate Pathology. DAKO; 2013. 20 p.
- Paltsev MA, Kakturskiy LV, Zayratyants OV, editors. [Pathological anatomy: national guide-lines]. Moscow: GEOTAR-Media; 2011. 1264 p. Russian.
- Amin M, Boccon-Gibod L, Egevad L, Ep-stein JI, Humphrey PA, Mikuz G, Newling D, Nilsson S, Sakr W, Srigley JR, Wheeler TM, Montironi R. Prognostic and predictive factors and reporting of prostate carcinoma in prostate needle biopsy specimes. Scand J Urol. Nephrol Suppl. 2005; 216:20-33.
- Hedrick L, Epstein JI. Use of keratin 903 as an adjunct in the diagnosis of prostate carcinoma. Am J Surg Pathol. 1989;13(5):389-96.
- Signoretti S, Waltregny D, Dilks J, Isaac B, Lin D, Garraway L, Yang A, Montironi R, McKeon F, Loda M. p63 is a prostate basal cell marker and is required for prostate development. Am J Pathol. 2000;57(6):1769-75.
- Weinstein MH, Signoretti S, Loda M. Diagnostic utility of immunohistochemical staining for p63, a sensitive marker of prostatic basal cells. Mod Pathol. 2002;15(12):1302-8.
- Brawer MK, Peehl DM, Stamey TA, Bostwick DG. Keratin immunore activity in the benign and neoplastic human prostate. Cancer Res. 1985;45(8):3663-7.
- Paner GP, Luthringer DJ, Amin MB. Best practice in diagnostic immunohistochemistry: prostate carcinoma and its mimics in needle core biop-sies. Arch Pathol Lab Med 2008; 132(9):1388-96.
- Lloyd MD, Darley DJ, Wierzbicki AS, Threadgill MD. Alpha-methylacyl-CoA racemase - an 'obscure' metabolic enzyme takes centre stage. FEBS. 2008;275(6):1089-102.
- Went PT, Sauter G, Oberholzer M, Bubendorf L. Abundant expression of AMACR in many distinct tumour types. Pathol. 2006;38(5):426-32.
- Jiang Z, Wu CL, Woda BA, Iczkowski KA, Chu PG, Tretiakova MS, Young RH, Weiss LM, Blute RD Jr, Brendler CB, Krausz T, Xu JC, Rock KL, Amin MB, Yang XJ. Alpha-methylacyl-CoA racemase: a multi-institutional study of a new prostate cancer marker. Histopathol. 2004;45(3):218-25.
- Carswell BM, Woda BA, Wang X, Li C, Dresser K, Jiang Z. Detection of prostate cancer by alpha-methylacyl CoA racemase (P504S) in needle biopsy specimens previously reported as negative for malignancy. Histopathol. 2006;48(6):668-73.
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