34BetaE12 and Alfa-Methylacyl Coenzyme A Racemase (AMACR) Antibodies Better Than p63 Antibody Distinguish Normal and Neoplastic Glands in Prostatic Tissue With Thermal Artifacts

摘要

Positive surgical margin after prostatectomy for clinically localized prostate cancer is an independent predictor of disease recurrence in addition to Gleason score and pathologic stage.1"4 Moreover, in samples from transure-thral resection of prostate (TURP), a diagnosis of unsuspected and/or incidentally discovered carcinoma determines a dramatic clinical and therapeutic change in the patient management, according to the pathologic stage. The occurrence of inked margins with crush artifact derived from the electrocauterization in radical prostatectomy and/ or after TURP can induce a significant interobserver variability during histopathologic evaluation of specimens.5"8 The specific immunostaining for (1) 34BetaE12 and p63 in basal cell and for (2) alfa-methylacyl coenzyme A racemase (AMACR) in neoplastic cells is commonly used as an ancillary tool to establish benign and malignant glands.9'10 In fact, the majority of prostate carcinomas lack basal cell layer and are positive for AMACR, whereas benign prostatic lesions showed positivity for basal cell markers and negativity for AMACR. In numerous laboratories 2-color triple antibody stain made up of AMACR, 34Be-taE12, and p63 was performed to distinguish benign from neoplastic glands. Given that, the cytoplasmatic positivity for 34BetaE12 and AMACR and the nuclear staining for p63 identify benign prostatic glands; the absence of nuclear basal cell markers and the positivity for AMACR represents a typical marker of neoplastic glands. In this study we carried out an immunohistochemical reactions for p63, 34BetaE12, and AMACR on 3 different and successive paraffin sections to discriminate malignant and benign prostatic glands distorted and crushed by the thermal artifacts.