Diagnostic utility of immunohistochemistry in morphologically difficult prostate cancer: Review of current literature

  • M. V
  • B. J
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Immunohistochemistry is widely used to distinguish prostate cancer from benign mimics and to establish the prostatic origin of poorly differentiated carcinoma. We critically review the recent advances in prostate cancer immunohistochemistry, including the introduction of newer basal cell markers such as p63 and the discovery of the overexpression of α-methylacyl coenzyme A racemase (AMACR) in prostate cancer. The description of newer urothelial markers to aid the distinction of prostate cancer from urothelial carcinoma is also presented together with refinements in the quality control of PSA and PSAP immunostaining. Although AMACR is a useful immunohistochemical marker for prostate cancer, it has significant limitations. These limitations are discussed and the need for interpreting AMACR immunoreactivity in the appropriate morphological context and in conjunction with basal call markers is emphasized. We also describe the utility of an immunohistochemical panel composed of PSA, PSAP and high molecular weight cytokeratin for distinguishing poorly differentiated prostate cancer from high-grade urothelial carcinoma. A morphological differential diagnosis based selection of immunohistochemical markers is highlighted as a novel approach in the diagnosis of prostate cancer in routine surgical pathology practice. © 2005 Blackwell Publishing Limited.

Author-supplied keywords

  • 2 methylacyl coenzyme A racemase
  • Gleason score
  • acinar cell carcinoma
  • bladder carcinoma
  • breast adenocarcinoma
  • carcinoembryonic antigen
  • carcinoid
  • colon adenocarcinoma
  • controlled study
  • cystitis
  • cytokeratin
  • cytokeratin 1
  • cytokeratin 10
  • cytokeratin 14
  • cytokeratin 18
  • cytokeratin 5
  • cytokeratin 6
  • diagnostic value
  • differential diagnosis
  • human
  • human tissue
  • immunohistochemistry
  • male
  • melanoma
  • needle biopsy
  • pancreas islet cell tumor
  • perianal gland
  • priority journal
  • prostate cancer
  • prostate hypertrophy
  • prostate specific antigen
  • protein expression
  • protein p53
  • protein p63
  • quality control
  • review
  • salivary gland tumor
  • seminal vesicle
  • sensitivity and specificity
  • thrombomodulin
  • thyroid transcription factor 1
  • transurethral resection
  • uroplakin

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  • Varma M.

  • Jasani B.

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