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Published in: Diagnostic Pathology 1/2011

Open Access 01-12-2011 | Research

Diagnostic utility of p63/P501S double sequential immunohistochemical staining in differentiating urothelial carcinoma from prostate carcinoma

Authors: Malini Srinivasan, Anil V Parwani

Published in: Diagnostic Pathology | Issue 1/2011

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Abstract

Background

Distinguishing urothelial carcinoma (UC) from prostate carcinoma (PC) is important due to potential therapeutic and prognostic implications. However, this can be a diagnostic challenge when there is limited tissue and in poorly differentiated tumors. We evaluated the diagnostic utility of a dual immunohistochemical stain comprising p63 and P501S (prostein), applied sequentially on a single slide and visualized by double chromogen reaction, in differentiating these two cancers. Thus far, there have been no previous studies assessing the diagnostic utility of p63 and P501S combined together as a dual immunostain in distinguishing between these two cancers.

Methods

p63/P501S dual-color sequential immunohistochemical staining was performed on archival material from 132 patients with high-grade UC and 23 patients with PC, and evaluated for p63 (brown nuclear) and P501S (red cytoplasmic) expression. Both the staining intensity and percentage of positive tumor cells were assessed.

Results

p63 was positive in 119/132 of UC and negative in PC. P501S was positive in 22/23 of PC and negative in UC. The p63+/P501S- immunoprofile had 90% sensitivity and 100% specificity for UC. The p63-/P501S+ immunoprofile had 96% sensitivity and 100% specificity for PC.

Conclusion

Our results indicate that double sequential immunohistochemical staining with p63 and P501S is highly specific and can be a useful tool in distinguishing UC from PC especially when there is limited diagnostic tissue as it can be performed on a single slide.
Appendix
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Literature
1.
go back to reference Aihara M, Lebovitz RM, Wheeler TM, Kinner BM, Ohori M, Scardino PT: Prostate specific antigen and gleason grade: an immunohistochemical study of prostate cancer. J Urol. 1994, 151: 1558-1564.PubMed Aihara M, Lebovitz RM, Wheeler TM, Kinner BM, Ohori M, Scardino PT: Prostate specific antigen and gleason grade: an immunohistochemical study of prostate cancer. J Urol. 1994, 151: 1558-1564.PubMed
2.
go back to reference Goldstein NS: Immunophenotypic characterization of 225 prostate adenocarcinomas with intermediate or high Gleason scores. Am J Clin Pathol. 2002, 117: 471-477. 10.1309/G6PR-Y774-X738-FG2K.CrossRefPubMed Goldstein NS: Immunophenotypic characterization of 225 prostate adenocarcinomas with intermediate or high Gleason scores. Am J Clin Pathol. 2002, 117: 471-477. 10.1309/G6PR-Y774-X738-FG2K.CrossRefPubMed
3.
go back to reference Chuang AY, DeMarzo AM, Veltri RW, Sharma RB, Bieberich CJ, Epstein JI: Immunohistochemical differentiation of high-grade prostate carcinoma from urothelial carcinoma. Am J Surg Pathol. 2007, 31: 1246-1255. 10.1097/PAS.0b013e31802f5d33.CrossRefPubMed Chuang AY, DeMarzo AM, Veltri RW, Sharma RB, Bieberich CJ, Epstein JI: Immunohistochemical differentiation of high-grade prostate carcinoma from urothelial carcinoma. Am J Surg Pathol. 2007, 31: 1246-1255. 10.1097/PAS.0b013e31802f5d33.CrossRefPubMed
4.
go back to reference Jiang Z, Fanger GR, Woda BA, Banner BF, Algate P, Dresser K, et al.: Expression of alpha-methylacyl-CoA racemase (P504s) in various malignant neoplasms and normal tissues: astudy of 761 cases. Hum Pathol. 2003, 34: 792-796. 10.1016/S0046-8177(03)00268-5.CrossRefPubMed Jiang Z, Fanger GR, Woda BA, Banner BF, Algate P, Dresser K, et al.: Expression of alpha-methylacyl-CoA racemase (P504s) in various malignant neoplasms and normal tissues: astudy of 761 cases. Hum Pathol. 2003, 34: 792-796. 10.1016/S0046-8177(03)00268-5.CrossRefPubMed
5.
go back to reference Kalos M, Askaa J, Hylander BL, Repasky EA, Cai F, Vedvick T, et al.: Prostein expression is highly restricted to normal and malignant prostate tissues. Prostate. 2004, 60: 246-256. 10.1002/pros.20043.CrossRefPubMed Kalos M, Askaa J, Hylander BL, Repasky EA, Cai F, Vedvick T, et al.: Prostein expression is highly restricted to normal and malignant prostate tissues. Prostate. 2004, 60: 246-256. 10.1002/pros.20043.CrossRefPubMed
6.
go back to reference Xu J, Kalos M, Stolk JA, Zasloff EJ, Zhang X, Houghton RL, et al.: Identification and characterization of prostein, a novel prostate-specific protein. Cancer Res. 2001, 61: 1563-1568.PubMed Xu J, Kalos M, Stolk JA, Zasloff EJ, Zhang X, Houghton RL, et al.: Identification and characterization of prostein, a novel prostate-specific protein. Cancer Res. 2001, 61: 1563-1568.PubMed
7.
go back to reference Hodges KB, Lopez-Beltran A, Emerson RE, Montironi R, Cheng L: Clinical utility of immunohistochemistry in the diagnoses of urinary bladder neoplasia. Appl Immunohistochem Mol Morphol. 2010, 18: 401-410.PubMed Hodges KB, Lopez-Beltran A, Emerson RE, Montironi R, Cheng L: Clinical utility of immunohistochemistry in the diagnoses of urinary bladder neoplasia. Appl Immunohistochem Mol Morphol. 2010, 18: 401-410.PubMed
8.
go back to reference Parker DC, Folpe AL, Bell J, Oliva E, Young RH, Cohen C, et al.: Potential utility of uroplakin III, thrombomodulin, high molecular weight cytokeratin, and cytokeratin 20 in noninvasive, invasive, and metastatic urothelial (transitional cell) carcinomas. Am J Surg Pathol. 2003, 27: 1-10. 10.1097/00000478-200301000-00001.CrossRefPubMed Parker DC, Folpe AL, Bell J, Oliva E, Young RH, Cohen C, et al.: Potential utility of uroplakin III, thrombomodulin, high molecular weight cytokeratin, and cytokeratin 20 in noninvasive, invasive, and metastatic urothelial (transitional cell) carcinomas. Am J Surg Pathol. 2003, 27: 1-10. 10.1097/00000478-200301000-00001.CrossRefPubMed
9.
go back to reference Ordonez NG: Thrombomodulin expression in transitional cell carcinoma. Am J Clin Pathol. 1998, 110: 385-390.PubMed Ordonez NG: Thrombomodulin expression in transitional cell carcinoma. Am J Clin Pathol. 1998, 110: 385-390.PubMed
10.
go back to reference Kaufmann O, Volmerig J, Dietel M: Uroplakin III is a highly specific and moderately sensitive immunohistochemical marker for primary and metastatic urothelial carcinomas. Am J Clin Pathol. 2000, 113: 683-687. 10.1309/PYQC-17CB-063T-Q07J.CrossRefPubMed Kaufmann O, Volmerig J, Dietel M: Uroplakin III is a highly specific and moderately sensitive immunohistochemical marker for primary and metastatic urothelial carcinomas. Am J Clin Pathol. 2000, 113: 683-687. 10.1309/PYQC-17CB-063T-Q07J.CrossRefPubMed
11.
go back to reference Higgins JP, Kaygusuz G, Wang L, Montgomery K, Mason V, Zhu SX, et al.: Placental S100 (S100P) and GATA3: markers for transitional epithelium and urothelial carcinoma discovered by complementary DNA microarray. Am J Surg Pathol. 2007, 31: 673-680. 10.1097/01.pas.0000213438.01278.5f.CrossRefPubMed Higgins JP, Kaygusuz G, Wang L, Montgomery K, Mason V, Zhu SX, et al.: Placental S100 (S100P) and GATA3: markers for transitional epithelium and urothelial carcinoma discovered by complementary DNA microarray. Am J Surg Pathol. 2007, 31: 673-680. 10.1097/01.pas.0000213438.01278.5f.CrossRefPubMed
12.
go back to reference Di Como CJ, Urist MJ, Babayan I, Drobnjak M, Hedvat CV, Teruya-Feldstein J, et al.: p63 expression profiles in human normal and tumor tissues. Clin Cancer Res. 2002, 8: 494-501.PubMed Di Como CJ, Urist MJ, Babayan I, Drobnjak M, Hedvat CV, Teruya-Feldstein J, et al.: p63 expression profiles in human normal and tumor tissues. Clin Cancer Res. 2002, 8: 494-501.PubMed
13.
go back to reference Nekulova M, Holcakova J, Coates P, Vojtesek B: The role of p63 in cancer, stem cells and cancer stem cells. Cell Mol Biol Lett. 2011, 16: 296-327. 10.2478/s11658-011-0009-9.CrossRefPubMed Nekulova M, Holcakova J, Coates P, Vojtesek B: The role of p63 in cancer, stem cells and cancer stem cells. Cell Mol Biol Lett. 2011, 16: 296-327. 10.2478/s11658-011-0009-9.CrossRefPubMed
14.
go back to reference Varma M, Jasani B: Diagnostic utility of immunohistochemistry in morphologically difficult prostate cancer: review of current literature. Histopathology. 2005, 47: 1-16. 10.1111/j.1365-2559.2005.02188.x.CrossRefPubMed Varma M, Jasani B: Diagnostic utility of immunohistochemistry in morphologically difficult prostate cancer: review of current literature. Histopathology. 2005, 47: 1-16. 10.1111/j.1365-2559.2005.02188.x.CrossRefPubMed
15.
go back to reference Kunju LP, Mehra R, Snyder M, Shah RB: Prostate-specific antigen, high-molecular-weight cytokeratin (clone 34betaE12), and/or p63: an optimal immunohistochemical panel to distinguish poorly differentiated prostate adenocarcinoma from urothelial carcinoma. Am J Clin Pathol. 2006, 125: 675-681. 10.1309/V1RY91NKX5ARW2Q5.CrossRefPubMed Kunju LP, Mehra R, Snyder M, Shah RB: Prostate-specific antigen, high-molecular-weight cytokeratin (clone 34betaE12), and/or p63: an optimal immunohistochemical panel to distinguish poorly differentiated prostate adenocarcinoma from urothelial carcinoma. Am J Clin Pathol. 2006, 125: 675-681. 10.1309/V1RY91NKX5ARW2Q5.CrossRefPubMed
16.
go back to reference Sheridan T, Herawi M, Epstein JI, Illei PB: The role of P501S and PSA in the diagnosis of metastatic adenocarcinoma of the prostate. Am J Surg Pathol. 2007, 31: 1351-1355. 10.1097/PAS.0b013e3180536678.CrossRefPubMed Sheridan T, Herawi M, Epstein JI, Illei PB: The role of P501S and PSA in the diagnosis of metastatic adenocarcinoma of the prostate. Am J Surg Pathol. 2007, 31: 1351-1355. 10.1097/PAS.0b013e3180536678.CrossRefPubMed
17.
go back to reference Yin M, Dhir R, Parwani AV: Diagnostic utility of p501s (prostein) in comparison to prostate specific antigen (PSA) for the detection of metastatic prostatic adenocarcinoma. Diagn Pathol. 2007, 2: 41-10.1186/1746-1596-2-41.PubMedCentralCrossRefPubMed Yin M, Dhir R, Parwani AV: Diagnostic utility of p501s (prostein) in comparison to prostate specific antigen (PSA) for the detection of metastatic prostatic adenocarcinoma. Diagn Pathol. 2007, 2: 41-10.1186/1746-1596-2-41.PubMedCentralCrossRefPubMed
18.
go back to reference Lane Z, Hansel DE, Epstein JI: Immunohistochemical expression of prostatic antigens in adenocarcinoma and villous adenoma of the urinary bladder. Am J Surg Pathol. 2008, 32: 1322-1326. 10.1097/PAS.0b013e3181656ca0.CrossRefPubMed Lane Z, Hansel DE, Epstein JI: Immunohistochemical expression of prostatic antigens in adenocarcinoma and villous adenoma of the urinary bladder. Am J Surg Pathol. 2008, 32: 1322-1326. 10.1097/PAS.0b013e3181656ca0.CrossRefPubMed
19.
go back to reference Farinola MA, Epstein JI: Utility of immunohistochemistry for alpha-methylacyl-CoA racemase in distinguishing atrophic prostate cancer from benign atrophy. Hum Pathol. 2004, 35: 1272-1278. 10.1016/j.humpath.2004.06.015.CrossRefPubMed Farinola MA, Epstein JI: Utility of immunohistochemistry for alpha-methylacyl-CoA racemase in distinguishing atrophic prostate cancer from benign atrophy. Hum Pathol. 2004, 35: 1272-1278. 10.1016/j.humpath.2004.06.015.CrossRefPubMed
20.
go back to reference Osunkoya AO, Hansel DE, Sun X, Netto GJ, Epstein JI: Aberrant diffuse expression of p63 in adenocarcinoma of the prostate on needle biopsy and radical prostatectomy: report of 21 cases. Am J Surg Pathol. 2008, 32: 461-467. 10.1097/PAS.0b013e318157020e.CrossRefPubMed Osunkoya AO, Hansel DE, Sun X, Netto GJ, Epstein JI: Aberrant diffuse expression of p63 in adenocarcinoma of the prostate on needle biopsy and radical prostatectomy: report of 21 cases. Am J Surg Pathol. 2008, 32: 461-467. 10.1097/PAS.0b013e318157020e.CrossRefPubMed
21.
go back to reference Varma M, Morgan M, Amin MB, Wozniak S, Jasani B: High molecular weight cytokeratin antibody (clone 34betaE12): a sensitive marker for differentiation of high-grade invasive urothelial carcinoma from prostate cancer. Histopathology. 2003, 42: 167-172. 10.1046/j.1365-2559.2003.01560.x.CrossRefPubMed Varma M, Morgan M, Amin MB, Wozniak S, Jasani B: High molecular weight cytokeratin antibody (clone 34betaE12): a sensitive marker for differentiation of high-grade invasive urothelial carcinoma from prostate cancer. Histopathology. 2003, 42: 167-172. 10.1046/j.1365-2559.2003.01560.x.CrossRefPubMed
Metadata
Title
Diagnostic utility of p63/P501S double sequential immunohistochemical staining in differentiating urothelial carcinoma from prostate carcinoma
Authors
Malini Srinivasan
Anil V Parwani
Publication date
01-12-2011
Publisher
BioMed Central
Published in
Diagnostic Pathology / Issue 1/2011
Electronic ISSN: 1746-1596
DOI
https://doi.org/10.1186/1746-1596-6-67

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