Diagnostic utility of α-methylacyl CoA racemase P504S and HMWCK in morphologically difficult prostate cancerReportar como inadecuado




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Diagnostic Pathology

, 5:83

First Online: 22 December 2010Received: 16 October 2010Accepted: 22 December 2010

Abstract

BackgroundTo evaluate the diagnostic utility of alpha-methylacyl CoA racemase P504S and HMWCK 34beta E12 in morphologically difficult prostate cancer.

MethodsA total of 1034 cases were reviewed and divided into benign 585 malignant 399 and suspicious 50. Immunohistochemistry with HMWCK and AMACR was done on the 50 suspicious cases along with controls.

ResultsForty nine suspicious cases were resolved by using both markers where as 1 case was resolved by further support with CD68. The original diagnosis was changed in 15 of 50 30% suspicious cases from benign to malignant, one case from benign to high grade PIN and in one case from malignant to benign. Change of diagnosis was seen in 17 of 50 34% suspicious cases with a significant p value of 0.002. The overall diagnosis was changed in 17 of 1034 cases 1.64% of prostatic disease p < 0.001.

ConclusionsA combination of HMWCK and AMACR is of great value in combating the morphologically suspicious cases and significantly increasing the diagnostic accuracy in prostate cancer. Although, in this study the sensitivity and specificity of HMWCK and AMACR were high, yet it should be used with caution, keeping in mind all their pitfalls and limitations.

AbbreviationsAMACRα-methylacyl CoA racemase

ASAPatypical small acinar proliferation

ADENadenosis

ATFatypical foci

BCHbasal cell hyperplasia

BPHbenign prostatic hyperplasia

CATcategory

CMcamouflaged morphology

HGPINhigh grade prostatic intraepithelial neoplasia

HMWCKhigh molecular weight cytokeratin

INFLinflammation

NEMno evidence of malignancy

PCprostate carcinoma

TURPtransurethral resection prostate.

Electronic supplementary materialThe online version of this article doi:10.1186-1746-1596-5-83 contains supplementary material, which is available to authorized users.

K Kumaresan, Nandita Kakkar, Alka Verma, Arup Kumar Mandal, Shrawan Kumar Singh and Kusum Joshi contributed equally to this work.

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Autor: K Kumaresan - Nandita Kakkar - Alka Verma - Arup Kumar Mandal - Shrawan Kumar Singh - Kusum Joshi

Fuente: https://link.springer.com/







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