Immunohistochemical stains for p63 and α-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
Immunohistochemical stains for p63 and α-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
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DOI：
10.1097/01.pas.0000157936.93999.18
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发表时间：
2005-05-01
影响因子：
5.6
通讯作者：
Humphrey, PA
中科院分区：
文献类型：
--
作者：
Hameed, O;Sublett, J;Humphrey, PA
前列腺癌，尤其是微小前列腺癌的诊断有时会对针芯活检具有挑战性，偶尔免疫组化也有助于诊断。免疫染色剂，如针对基底细胞标志物p63的那些，以及最近采用与α-甲酰基-CoA消旋酶（AMACR）反应的抗体，在这种情况下可以是有用的。本研究的目的是评估p63/AMACR抗体混合物的诊断效用，并将其产生的染色模式与单独使用单个抗体的染色模式进行比较。对31例连续根治性前列腺切除术标本和150例前列腺穿刺活检样本进行回顾性分析，以选择显示前列腺癌和/或微小前列腺癌病灶、高级别前列腺上皮内瘤变（HGPIN）以及前列腺癌常见良性模拟物的组织学切片，包括萎缩和基底细胞增生，尤其是核仁突出。用苏木精和伊红以及p63、AMACR和包含两者的预稀释抗体混合物的免疫染色剂对来自相应石蜡块的连续组织切片进行染色。评估了鸡尾酒的诊断效用，并将其产生的染色特征与使用单个免疫染色剂的染色特征进行了比较。在430个病灶中，混合物产生与使用单一p63抗体相同的p63染色谱。区分细胞核p63信号从细胞质AMACR定位很容易完成。在使用混合物和单独的单一AMACR抗体的AMACR染色谱之间存在极好的一致性（kappa = 0.91; P < 0.0001）。鸡尾酒是非常有用的突出前列腺癌与HGPIN，平坦和筛状HGPIN，和扭曲的最小前列腺癌灶。这些数据表明，使用p63/AMACR混合物基本上等同于分别使用每种抗体用于针吸活组织检查中前列腺癌诊断的免疫组织化学确认。当只有有限的组织可用于前列腺穿刺活检组织中小的、诊断困难的病灶的免疫组化评价时，这种混合物将具有诊断实用性。
The diagnosis of prostatic carcinoma and especially minimal prostatic carcinoma can sometimes be challenging on needle core biopsy and occasionally immunohistochemistry is an aid in the diagnosis. Immunostains, such as those directed against the basal cell marker p63 and, more recently, employing antibodies reactive with alpha-methylacyl-CoA racemase (AMACR), can be useful in this situation. The aim of this investigation was to assess the diagnostic utility of a p63/AMACR antibody cocktail and compare the staining pattern it produces with that using the individual antibodies alone. A retrospective review of 31 consecutive radical prostatectomy specimens and 150 prostate needle biopsy samples was performed to select histologic sections showing foci of prostatic carcinoma and/or minimal prostatic carcinoma, high-grade prostatic intraepithelial neoplasia (HGPIN), as well as common benign mimickers of prostatic carcinoma, to include atrophy and basal cell hyperplasia, especially with prominent nucleoli. Serial histologic sections from the corresponding paraffin blocks were stained with hematoxylin and eosin and by immunostains for p63, AMACR, and a prediluted antibody cocktail comprising both. The diagnostic utility of the cocktail was assessed, and the staining characteristics it produced were compared with those using the individual immumostains. In 430 foci, the cocktail produced a p63 staining profile identical to that using the single p63 antibody. Distinction of the nuclear p63 signal from the cytoplasmic AMACR localization was readily accomplished. There was an excellent agreement (kappa = 0.91; P < 0.0001) between the AMACR staining profile using the cocktail and the single AMACR antibody alone. The cocktail was very useful in highlighting prostatic carcinoma associated with HGPIN, flat and cribriform HGPIN, and distorted foci of minimal prostatic carcinoma. These data indicate that use of a p63/AMACR cocktail is essentially equivalent to use of each antibody separately for immunohistochemical confirmation of a diagnosis of prostatic carcinoma in needle biopsy. This cocktail would be of diagnostic utility when only limited tissue is available for immunohistochemical evaluation of small, diagnostically difficult foci in prostate needle biopsy tissue.