Diagnostic Utility of Immunohistochemical Markers in Prostate Cancer
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 3
Abstract
Introduction: Prostate cancer is a multifaceted disease comprises distinct biological subtypes with varied spectrum of clinical, pathologic and molecular features with different prognostic and therapeutic implications. Over the last few decades there have been outstanding advances in prostate cancer management leading to earlier detection of disease. Prostatic cancer diagnosis is based on a combination of architectural, cytological and ancillary features. Immunohistochemistry (IHC) is a valuable adjunctive in diagnosis of minute foci of prostatic carcinoma and to differentiate it from benign mimickers & precursor lesions. Prostate cancer is now the 5th most common cancer in the world (in terms of number of new cases), and 2nd most common cancer in men. Aims of study :1) To assess the diagnostic utility of IHC markers in morphologically ambiguous prostate carcinomas 2) To assess the efficacy of P63 over HMWCK 3) To know the level of diagnostic error in reporting of Prostatic lesions on routine H&E. Materials &Methods : The Present study is a prospective study carried for a period of two years from June 2011 to May 2013 in Department of Pathology, Rangaraya medical college / Government general hospital, Kakinada. We received 310 cases of prostate biopsies in our department in the two year period. Out of the 310 cases, 40 cases were reported as suspicious of malignancy on H&E and are subjected for IHC. Results &Analysis : 40 suspicious cases were subjected for IHC. Out of 40 cases, in only 20 cases (50%) there is disparity between diagnosis on H&E and diagnosis on IHC. In 20 cases, 14 cases (35%) were underdiagnosed as benign or pre-malignant or suspicious of malignancy. These got upgraded to HGPIN or carcinoma or carcinoma with foci of HGPIN after IHC study. Remaining 6 cases (15%) are downgraded from pre-malignant lesions to benign lesions. Discussion : Our results are almost correlated with other studies. Conclusion : 1.Even though diagnosis of prostate cancer is mainly based on architectural pattern, cytological and ancillary features, Immunohistochemistry acts as a most valuable adjunctive, which significantly increases the diagnostic accuracy in prostatic carcinoma. 2.Among basal cell markers, p63 has more sensitivity and specificity than HMWCK. 3.No single marker is having 100% sensitivity or specificity in diagnosis of prostatic carcinoma. Hence combination of a Basal cell marker (p63) with AMACR is more informative in the diagnosis of prostatic carcinoma.
Authors and Affiliations
Dr. O. D. E. Anand, Dr. P. Satyanarayana Rao, Dr. Ch. Kishore Kumar, Dr. R. Vijaya Bhaskar
Keywords
Related Articles
- EP ID EP600144
- DOI 10.9790/0853-1603092228.
- Views 76
- Downloads 0
Amniotic Band Syndrome: An Unusual Presentation
Amniotic band syndrome (ABS) is a set of congenital malformations attributed toamniotic bands that entangle fetal parts during intrauterine life, which results in a broad spectrum of anatomic disturbances - ranging from...
Original Article: Study of Prvalence of Diabetes Mellitus in Tertiary Centre of Sagar
Introduction: To study the prevalence of diabetes mellitus in urban population of sagar. Methods; A total of 1000 individuals who came for regular check up in Bundelkhand Medical college sagar were screened for Fasting c...
A study on Factors Influencing in Acceptance of Vasectomy
Context: Vasectomy is safe, simple, procedure without major complications, no deaths, fewer selected as family planning method, low prevalence rate of 3.9% in Andhra Pradesh, compared to 95.6% tubectomies with complicati...
Observation and Management of Cases of Acute Abdomen Admitted In Dmch Emergency
Introduction: Acute abdomen is all time enigma, rightly described as Pandora’s box by Desai and Irani1 . It is an Intra-abdominal condition of abrupt onset usually associated with pain due to Inflammation, perforation, o...
Spectrum of Shoulder Pathologies:Retrospective Analysis ofMRI Shoulder ofIndustrial Workers Presenting With Shoulder Pain
Shoulder pain is a significant cause of morbidity in manual labourers. Shoulder pain increases the financial burden towards health care expenses. Our aim was to study the spectrum of shoulder pathologies in manual labour...