IJCRR - 7(6), March, 2015
Pages: 07-14
MINIMAL ADENOCARCINOMA IN PROSTATE NEEDLE BIOPSY TISSUE: IMMUNOHISTOCHEMICAL STUDY
Author: Hayam E. Rashed, Abdelmonem A. Hegazy, Ragab A. Ahmed
Category: Healthcare
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Abstract:
Background: Diagnosis of small foci of prostate cancer in a core biopsy is one of the major diagnostic challenges. Immunohistochemistry plays an important role in the diagnosis of minimal prostate cancer and to exclude the benign lesions. The α-methylacyl CoA racemase (AMACR) and p63 have been used for such purpose.
Aim of work: To investigate which basal cell marker; 34βE12 or p63 should be the first choice used with AMACR to increase diagnostic accuracy of minimal prostate cancer in core biopsy, in a trial to reduce the errors in diagnosis and to decrease the need for repeated biopsies.
Methods: Sections from formalin-fixed paraffin-embedded tissues of 60 prostate needle biopsy specimens were stained immunohistochemically with 34βE12, p63, Ki-67 and AMACR.
Results: AMACR was expressed in 90% of minimal prostatic carcinoma. Nuclei of basal cells in 90% of normal glands were stained for p63. Regarding 34βE12, all benign subjects showed linear cytoplasmic basal staining. 34βE12 had very high sensitivity and specificity values (96.3% and 100%, respectively), followed by p63 (97.9% and 85.3%). There were significant differences in cytoplasmic p63 expression between benign tissue and prostate cancer, and between low and high grade carcinoma (P <0.001). It was also found that higher levels of cytoplasmic p63 were significantly associated with higher frequency of proliferating cells.
Conclusions: Combined assessment of 34βE12 and p63 as a negative (cytoplasmic and nuclear, respectively) marker and AMACR as a positive marker for identifying prostate adenocarcinoma could greatly improve the diagnosis of minimal prostate cancer in needle biopsy specimens.
Keywords: Prostate, Minimal adenocarcinoma, AMACR, p63, 34?E12, Immunohistochemistry
Citation:
Hayam E. Rashed, Abdelmonem A. Hegazy, Ragab A. Ahmed. MINIMAL ADENOCARCINOMA IN PROSTATE NEEDLE BIOPSY TISSUE: IMMUNOHISTOCHEMICAL STUDY International Journal of Current Research and Review. 7(6), March, 07-14
References:
1. Herawi M, Parwani AV, Irie J, Epstein JI. Small Glandular Proliferations on Needle Biopsies, Most Common Benign Mimickers of Prostatic Adenocarcinoma Sent in for Expert Second Opinion. Am J Surg Pathol 2005;29(7):874-880.
2. Singh V, Manu V, Malik A, Dutta V, Mani NS, Patrikar S,. Diagnostic utility of p63 and α-methyl acyl Co A racemase in resolving suspicious foci in prostatic needle biopsy and transurethral resection of prostate specimens. J Cancer Res Ther 2014;10(3):686-692.
3. Iczkowski KA, Chen HM, Yang XJ, Beach RA. Prostate cancer diagnosed after initial biopsy with atypical small acinar proliferation suspicious for malignancy is similar to cancer found on initial biopsy. Urology 2002;60(5):851-854.
4. Molinié V, Hervé JM, Lugagne PM, Lebret T, Botto H. Diagnostic utility of a p63/α-methyl coenzyme A racemase (p504s) cocktail in ambiguous lesions of the prostate upon needle biopsy. BJU Int 2006;97(5):1109-1115.
5. Hameed O, Humphrey PA. Immunohistochemistry in the diagnosis of minimal prostate cancer. Diagnostic Histopathology 2006;12(4):279-291.
6. Kalantari MR, Anvari K, Jabbari H, Tabrizi FV. p63 is more sensitive and specific than 34βE12 to differentiate adenocarcinoma of prostate from cancer mimickers. Iran J Basic Med Sci. 2014;17(7):497-501.
7. Hameed O, Sublett J, Humphrey PA. Immunohistochemical stains for p63 and alpha-methylacyl-CoA racemase, versus a cocktail comprising both, in the diagnosis of prostatic carcinoma: a comparison of the immunohistochemical staining of 430 foci in radical prostatectomy and needle biopsy tissues, Am J Surg Pathol 2005;29(5):579-587.
8. Rashed EH, Kateb MI, Ragab AA, Shaker SS. Evaluation of minimal prostate cancer in needle biopsy specimens using AMACR (P504S), P63 and KI67. Life Sci J 2012;9(4):12-21
9. Abrahams NA, Ormsby AH, Brainard J. Validation of cytokeratin 5/6 as an effective substitute for keratin 903 in the differentiation of benign from malignant glands in prostate needle biopsies. Histopathology 2002;41(1):35- 41.
10. Shah RB, Zhou M, LeBlanc M, Snyder M, Rubin MA. Comparison of the basal cell-specific markers, 34βE12, and p63, in the diagnosis of prostate. Am J Surg Pathol 2002;26(9):1161-1168.
11. Zhou M, Aydin H, Kanane H, Epstein JI. How often does α-methylacyl-CoA-racemase contribute to resolving an atypical diagnosis on prostate needle biopsy beyond that provided by basal cell markers? Am J Surg Pathol 2004;28(2):239-243.
12. Dhillon PK, Barry M, Stampfer MJ, Perner S, Fiorentino M, Fornari A, et al. Aberrant cytoplasmic expression of p63 and prostate cancer mortality. Cancer Epidemiol Biomarkers Prev 2009;18(2):595-600.
13. Jiang Z, Woda BA, Rock KL, Xu Y, Savas L, Khan A, et al. P504S: a new molecular marker for the detection of prostate carcinoma. Am J Surg Pathol 2001;25(11):1397-1404.
14. Yang XJ, Wu CL, Woda BA, Dresser K, Tretiakova M, Fanger GR, et al. Expression of alphamethylacyl-CoA racemase (P504S) in atypical adenomatous hyperplasia of the prostate. Am J Surg Pathol 2002;26(7):921-925
15. Martens MB., Keller JH. Routine immunohistochemical staining for high-molecular weight cytokeratin 34βE12 and α-methylacyl CoA racemase (P504S) in postirradiation prostate biopsies. Modern Pathology 2006;19: 287-290.
16. Rubin MA, Zhou M, Dhanasekaran SM, Varambally S, Barrette TR, Sanda MG, et al. Alphamethylacyl coenzyme A racemase as a tissue biomarker for prostate cancer. JAMA 2002;287(13):1662-1670.
17. Jiang Z, Wu CL, Woda BA, Dresser K, Xu J, Fanger GR, et al. P504S/alphamethylacyl-CoA racemase: a useful marker for diagnosis of small foci of prostatic carcinoma on needle biopsy. Am J Surg Pathol 2002;26(9):1169-1174.
18. Beach R, Gown AM, De Peralta-Venturina MN, Folpe AL, Yaziji H, Salles PG, et al. P504S immunohistochemical detection in 405 prostatic specimens including 376 18-gauge needle biopsies. Am J Surg Pathol 2002;26(12):1588- 1596.
19. Boran C, Kandirali E, Yilmaz F, Serin E, Akyol M. Reliability of the 34βE12, keratin 5/6, p63, bcl-2, and AMACR in the diagnosis of prostate carcinoma. Urol Oncol 2011;29(6):614-623.
20. Farinola MA, Epstein JI. Utility of immunohistochemistry for alpha-methylacyl-CoA racemase in distinguishing atrophic prostate cancer from benign atrophy. Hum Pathol 2004;35(10):1272-1278.
21. Zhou M, Jiang Z, Epstein JI. Expression and diagnostic utility of alpha-methylacyl-CoA-racemase (P504S) in foamy gland and pseudohyperplastic prostate cancer. Am J Surg Pathol 2003;27(6):772-778.
22. Kahane H, Sharp JW, Shuman GB, Dasilva G, Epstein JI. Utilization of high molecular weight cytokeratin on prostate needle biopsies in an independent laboratory. Urology 1995;45(6):981- 986.
23. Signoretti S, Waltregny D, Dilks J, Isaac B, Lin D, Garraway L, et al. p63 is a prostate basal cell marker and is required for prostate development. Am J Pathol 2000;157(6):1769- 1775
24. Varma M, Linden MD, Amin MB. Effect of formalin fixation and epitope retrieval techniques on antibody 34betaE12 immunostaining of prostatic tissues. Mod Pathol 1999;12(5):472-478.
25. Lo Muzio L, Santarelli A, Caltabiano R, Rubini C, Pieramici T, Trevisiol L, et al. p63 overexpression associates with poor prognosis in head and neck squamous cell carcinoma. Hum Pathol 2005;36(2):187-194.
26. Marchini S, Marabese M, Marrazzo E, Mariani P, Cattaneo D, Fossati R, et al. DeltaNp63 expression is associated with poor survival in ovarian cancer. Ann Oncol 2008;19(3):501- 507.
27. Bismar TA, Demichelis F, Riva A, Kim R, Varambally S, He L, et al. Defining aggressive prostate cancer using a 12-gene model. Neoplasia 2006;8(1):59-68.
28. Mucci LA, Pawitan Y, Demichelis F, Fall K, Stark JR, Adami HO, et al. Testing a multigene signature of prostate cancer death in the Swedish Watchful Waiting Cohort. Cancer Epidemiol Biomarkers Prev 2008;17(7):1682-1688.
29. Narahashi T, Niki T, Wang T, Goto A, Matsubara D, Funata N, et al. Cytoplasmic localization of p63 is associated with poor patient survival in lung adenocarcinoma. Histopathology 2006;49(4):349-357.
30. Ferronika P, Triningsih FX, Ghozali A, Moeljono A, Rahmayanti S, Shadrina AN, et al. p63 Cytoplasmic Aberrance is Associated with High Prostate Cancer Stem Cell Expression. Asian Pacific J Cancer Prev 2012;13(5):1943-1948.
31. Parsons JK, Gage WR, Nelson WG, De Marzo AM. p63 Protein expression is rare in prostate adenocarcinoma: Implications for cancer diagnosis and carcinogenesis. Urology 2001;58(4):619-624.
32. Reiner T, De las Pozas A, Parrondo R, Perez-Stable C. Progression of prostate cancer from a subset of p63-positive basal epithelial cells in FG/Tag transgenic mice. Mol Cancer Res, 2007;5(11):1171-1179.
33. Fabbro M, Henderson BR. Regulation of tumor suppressors by nuclear-cytoplasmic shuttling. Exp Cell Res 2003;282(2):59-69.
34. Boldrup L, Coates PJ, Gu X, Nylander K. DeltaNp63 isoforms regulate CD44 and keratins 4, 6, 14 and 19 in squamous cell carcinoma of head and neck. J Pathol 2007;213(4):384-391.
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