Histopathological features of intra-ductal carcinoma of prostatic and high grade prostatic intraepithelialneoplasia and correlation with PTEN and P63.

BACKGROUND - The main morphologic differential diagnosis of intra-ductal carcinoma of prostate (IDC-P) is high grade prostatic intraepithelialneoplasia (HGPIN). Since IDC-P, unlike PIN, was strongly correlated with aggressive prostate cancer, differentiation of these is too necessary.

So we evaluated immunohistopathological patterns and the prognostic factors of IDC-P and HGPIN, in radical prostatectomy samples.

METHODS - We evaluated 250 radical prostatectomy and detected 210 cases of prostatic adenocarcinoma without IDC-P foci, 40 cases with adenocarcinoma concomitant IDC-P, and 40 cases HGPIN; therefore, we evaluated immunohistopathological criteria in these groups. Data were analyzed using SPSS and P-value <0. 05 was considered as the statistical significant level.

RESULTS - PSA level was significantly higher in IDC-P compared with non-IDC-P patients (15. 7 ± 3. 1 vs. 10. 2 ± 4. 3, P = 0. 041). All pathological and morphologic features, also invasions factors were higher in IDC-P compared to non-IDC-P groups (P < 0. 001). P63 was positive expressed in all IDC-P and HGPIN specimen. PTEN protein was diffusely expressed in the cytoplasm of all HGPIN but in 4 (11. 1%) of IDC-P. PTEN and P63 were negative in adenocarcinoma foci.

CONCLUSIONS - We found that IDC-P had a unique histoclinical feature and was strongly associated with poor prognostic factors. Diagnosis and report of IDC-P should be considered in all prostate specimens. Also, we recommend PTEN IHC application for differentiated IDC-P from HGPIN in biopsies. Prostate © 2015 Wiley Periodicals, Inc.

The Prostate. 2015 Dec 08 [Epub ahead of print]

Simin Torabi-Nezhad, Leila Malekmakan, Mohadese Mashayekhi, Arghavan Daneshian

Department of Pathology, Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. , Department of Community Medicine, Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. , Department of Pathology, Shiraz University of Medical Sciences, Shiraz, Iran. , Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

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