Immunohistochemical Differentiation of High-grade Prostate Carcinoma From Urothelial Carcinoma

• DOI: 10.1097/pas.0b013e31802f5d33
• Publication Date: 2007-07-23T08:04:06Z
• Authors: Ai-Ying Chuang; Angelo M. DeMarzo; Robert W. Veltri; Rajni B. Sharma; Charles J. Bieberich; Jonathan I. Epstein
• Keywords: Prostate carcinoma

The histologic distinction between high-grade prostate cancer and infiltrating urothelial may be difficult, has significant implications because each disease treated very differently (ie, hormone therapy for chemotherapy cancer). Immunohistochemistry of novel established prostatic markers using tissue microarrays (TMAs) were studied. Prostatic studied included: prostate-specific antigen (PSA), prostein (P501s), membrane (PSMA), NKX3.1 (an androgen-related tumor suppressor gene), proPSA (pPSA) (precursor form PSA). "Urothelial markers" included high molecular weight cytokeratin (HMWCK), p63, thrombomodulin, S100P (placental S100). TMAs contained 38 poorly differentiated cancers [Gleason score 8 (n=2), Gleason 9 (n=18), 10 (n=18)] 35 invasive carcinomas from radical prostatectomy cystectomy specimens, respectively. Each case had 2 to spots (0.6-mm diameter). If all a showed negative staining, the was called negative. sensitivities labeling PSA (97.4%), P501S (100%), PSMA (92.1%), (94.7%), pPSA (94.7%). Because PSA's sensitivity on TMA, we chose 41 additional primary (N=36) metastatic (N=5) which variable staining at time diagnosis performed immunohistochemistry routine sections. Compared PSA, average 18.8% cells with moderate strong positivity, cases stained P501S, PSMA, 42.5%, 53.7%, 52.9% immunoreactivity, All excellent specificity. HMWCK, lower in 91.4%, 82.9%, 68.6%, 71.4% These relatively specific only few showing scattered (<or=2%) weak-moderate positive cells. In summary, can used as first screening marker differentiating adenocarcinoma carcinoma. NKX3.1, are useful when is suspected based morphology or clinical findings, yet shows equivocal staining. HMWCK p63 superior thrombomodulin S100P.