DIAGNOSTIC UTILITY OF AMACR EXPRESSION TO DIFFERENTIATE PROSTATE CARCINOMA FROM BENIGN HYPERPLASIA OF PROSTATE- A HOSPITAL BASED CROSS-SECTIONAL STUDY
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2019, Vol 8, Issue 18
Abstract
BACKGROUND Prostatic carcinoma and Nodular Hyperplasia of Prostate (NHP) account for more than 90% of all prostatic diseases. Also, early symptoms of NHP and prostatic cancers are overlapping. However, the final diagnosis is always based on histopathological examination. Currently Trans-rectal ultrasound-guided core biopsy of prostate is the recommended modality of invasive investigation to rule out cancer in suspected cases. However, the lack of a prostate cancer–specific marker, which can be utilized in conjunction with routine histologic examination, remains a limitation. Few literatures have demonstrated the diagnostic usefulness of alpha-methyl-acyl-CoA-racemase (AMACR) in the detection of prostate cancer. We wanted to find out the sensitivity and specificity of this comparatively new marker and its usefulness in differentiating the benign and malignant lesions of prostate. METHODS All the core biopsies sent to the Department of Pathology from July 2016 to August 2018 were utilised in this observational crosssectional study. Only the biopsy reports which could be confirmed by routine H&E stain were included and reports having suspicious or ambiguous diagnosis by routine H&E stain were excluded from the study for further assessment by immunohistochemistry (IHC) marker under evaluation. For IHC, primary antibody was ‘Rabbit Monoclonal Antibody’ to AMACR. The AMACR staining was graded negative, weak or mild (weak non granular cytoplasmic stain), moderate (granular intensity with weak to moderate intensity), and strong (granular staining with strong intensity). RESULTS Out of a total of 106 cases, 68 cases (64.15%) had confirmed diagnosis of prostatic adenocarcinoma and rest 38 cases (35.85%) had confirmed diagnosis of benign hyperplasia of prostate by routine H & E method. Out of the total of 68 cases of prostatic adenocarcinoma, 60 cases (88.23%) show strong or moderate positive expression of AMACR in neoplastic glands while rest 8 cases (11.77%) show weak or negative expression of AMACR. Out of the total of 38 benign cases, only 2 cases (5.26%) show false positive expression of AMACR. Sensitivity and specificity of this IHC marker came out to be 88.24% and 94.74% respectively. CONCLUSIONS The present study proves that AMACR immunostaining has a very high specificity for diagnosis of prostate adenocarcinoma, but its sensitivity is slightly lower. Careful evaluation of morphologic pattern and combination with basal cell marker with AMACR immunostaining might be more useful for exclusion of prostate cancer in needle biopsy specimen.
Authors and Affiliations
Sanat Biswas, Manas Talukdar
Keywords
Related Articles
- EP ID EP616930
- DOI 10.14260/jemds/2019/319
- Views 106
- Downloads 0
STUDY ON HAEMORRHAGE IN 1ST TRIMESTER OF PREGNANCY AND ITS EVALUATION BY TRANSVAGINAL SONOGRAPHY
BACKGROUND Vaginal bleeding in the first trimester of pregnancy is a common obstetric problem and causes worry and anxiety both to the patient and the obstetrician. The first twelve weeks of intrauterine life are the mos...
PRIMARY CUTANEOUS NOCARDIOSIS- A DIAGNOSTIC DILEMMA
PRESENTATION OF CASE A 38-year-old male, working as a supermarket manager, developed multiple painful nodules on the face and arms associated with generalised weakness of 2 months duration. His medical history was otherw...
QUALITATIVE ANALYSIS OF DIGITAL DERMATOGLYPHICS IN A SMALL PATIENTS GROUP IN BOSNIA AND HERZEGOVINA
BACKGROUND Dermatoglyphics refers to epidermal ridges that typically form under genetic control in the early stage of development. The aforesaid skin ridges are very likely to be influenced by various external, i.e. envi...
A COMPARATIVE STUDY OF CLONIDINE AND DEXMEDETOMIDINE AS AN ADJUVANT IN SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK
BACKGROUND Supraclavicular block provides anaesthesia for upper extremity in the most consistent andf efficient manner of any brachial plexus technique. Adjuvants when added to local anaesthetics enhance the onset and pr...
TO COMPARE THE SENSITIVITY OF URINARY POLYMERASE CHAIN REACTION (PCR) WITH INTRAVENOUS UROGRAPHY (IVU) AND URINE ACID FAST BACILLI IN A CLINICALLY SUSPECTED CASE OF GENITO URINARY TUBERCULOSIS (GUTB)
BACKGROUND Tuberculosis is as old as human race. Introduction of Anti-tuberculosis drugs has reduced death due to this disease. About 30% of extra pulmonary TB involves uro-genital tract. Mostly sexually active age group...