engleski

Periacinar retraction clefting and p63 immunostaining in prostatic carcinoma

The diagnosis of prostate carcinoma is based on three major histologic criteria: the infiltrative growth pattern, the absence of basal cell layer, and the presence of macronucleoli. Basal cells are invariably absent from the malignant glands of prostate cancer. The ability of immunohistochemical staining to detect basal cells has proven to be diagnostically invaluable, especially in needle biopsy specimens. P63, a homolog of the tumor suppressor gene p53, has been shown in the basal cell component of epithelium from a variety of tissues, including prostate epithelium. One of the criteria favoring cancer is the presence of retraction clefting around neoplastic glands that is probably connected to the lack of basal cells. Therefore, the aim of this study was to correlate the presence and extent of retraction clefting and the expression of p63 in neoplastic glands in needle core biopsies. Fourteen cases with prostate carcinoma diagnosed on the basis of major and favoring criteria at Department of Pathology, Sestre milosrdnice University Hospital, were chosen for the study. The patients were aged 64-80 (mean 68.8) years. They underwent sextant biopsy after having an increased PSA serum value. In all cases retraction clefting was also described in biopsy findings. Immunohistochemical staining was performed following the Microwave Streptavidin ImmunoPeroxidase (MSIP) protocol on a DAKO TechMate Horizon automated immunostainer using antibodies to p63. Retraction clefting was observed in all 14 cases ; in 8 (57.2%) it affected more, and in 6 (42.8%) less than 50% of the gland circumference. p63 immunostaining was negative in all carcinoma cases but positive in adjacent normal glands. Our results strongly suggested a connection between the lack of basal cells in neoplastic glands and the development of retraction artifacts. The results also showed invariably negative staining for p63 in all cases with periacinar retraction artifacts. We conclude that the clefts represent a reliable diagnostic criterion and that staining for p63 might be useful when the clefts affect less than 50% of the gland circumference or are not present at all.

Prostatic carcinoma; p63

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