Evaluation of CK903 and P40 in distinguishing questionable prostatic lesions

Document Type : Original Article

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Pathology Department, Faculty of Medicine, Tanta University, Egypt

Abstract

Background: Prostatic carcinoma is considered the 2nd cause of death of cancers; the first is the lung cancer. Many pitfalls in the diagnosis of adenocarcinoma in cases of small foci of atypical glandular proliferations and high-grade PIN. Immunohistochemistry plays an important role in differentiating those lesions by staining basal cells. Basal cells recognition is extremely helpful in excluding a diagnosis of prostatic carcinoma. Aim: Aim: This study aimed to compare the expression of CK903 and P40 by benign and malignant prostatic lesions as well as their sensitivity and specificity as biomarkers to differentiate between benign and malignant glands. Results: CK903 showed cytoplasmic staining of the basal cells in all cases of benign prostatic hyperplasia, six out of seven HGPIN cases and only one case of prostatic adenocarcinoma. P40 showed nuclear staining of the basal cells in all cases of benign prostatic hyperplasia and HGPIN while all adenocarcinoma cases were negative to P40 immunostaining. P40 showed higher specificity, sensitivity and diagnostic accuracy than Ck903. Conclusion: P40 can be a reliable basal cell marker in questionable foci of prostatic biopsy specimens. CK 903 is better used in combination with other basal cell markers for more accurate diagnosis.

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