Correlation of Gleason Grading and Prognostic Immunohistochemistry Markers (Human Epidermal Growth Factor Receptor 2/neu and Androgen Receptor) in Prostatic Core Needle Biopsy: A Study in a Tertiary Care Center

Utsha Senapati; Moumita Sengupta; Chhanda Datta; Uttara Chatterjee; Dilip Kumar Pal; Diya Das; Piyali Poddar

doi:10.4103/ijmpo.ijmpo_139_17

Indian Journal of Medical and Paediatric Oncology, Table of Contents

CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2019; 40(02): 201-207
DOI: 10.4103/ijmpo.ijmpo_139_17

Original Article

Correlation of Gleason Grading and Prognostic Immunohistochemistry Markers (Human Epidermal Growth Factor Receptor 2/neu and Androgen Receptor) in Prostatic Core Needle Biopsy: A Study in a Tertiary Care Center

Utsha Senapati

Departments of Pathology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India

,

Moumita Sengupta

Departments of Pathology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India

,

Chhanda Datta

Departments of Pathology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India

,

Uttara Chatterjee

Departments of Pathology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India

,

Dilip Kumar Pal

Urosurgery, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India

,

Diya Das

Departments of Pathology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India

,

Piyali Poddar

Urosurgery, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India

› Author Affiliations

Abstract

Background: Worldwide prostate cancer is the most common cause of cancer and the second leading cause of cancer death among men. Transrectal ultrasound-guided core needle biopsies are the diagnostic modalities which help in proper categorization and grading of prostatic carcinoma, thus facilitating individualized treatment. These biopsies are the primary source for performance of additional diagnostic immunohistochemical testing for basal cell-associated markers to rule out the morphological mimicker and prognostic markers such as androgen receptor (AR) and human epidermal growth factor receptor 2 (HER2)/neu. Materials and Methods: A prospective, observational study was conducted in the department of pathology in collaboration with department of urosurgery of a tertiary care hospital. One hundred and nineteen patients diagnosed with prostatic nodules were included in this study. Values of serum prostate-specific antigen were recorded. Tissue for histopathological study was obtained in the form of core needle biopsy, and Gleason grade was calculated in all malignant cases. Immunohistochemistry for p63 and alpha-methylacyl-CoA racemase was performed as an additional test in premalignant cases. Prognostication of the prostate cancer cases was done using AR and HER2/neu. Results: A total of 119 cases aged between 20 and 90 years were included in this study. Malignant lesions reveal an increase in the percentage of AR staining in comparison to the benign glandular structure. The Gleason score with higher value (8–9) showed increased expression of HER2/neu receptor. Conclusion: Critical histopathological analysis of core needle biopsy along with immunohistochemical evaluation maximizes the diagnostic accuracy in prostate cancer cases and also helps in prognosis assessment.

Keywords

Androgen receptor - human epidermal growth factor receptor 2/neu - prostatic cancer - serum prostatic-specific antigen - transrectal ultrasound-guided core needle biopsies

Full Text

References

References
1 Emerging biomarkers for the detection and management of prostate carcinoma. chapter 19, Biopsy Interpretation Series. Biopsy Interpretation of the Prostate. In: Epstein JI, Netto GJ. editors 4th ed. USA: Lippincott Williams and Wilkins; 2008: 330-9
2 Epstein JI, Potter SR. The pathologic interpretation and significance of prostate needle biopsy findings: Implications and current controversies. J Urol 2001; 166: 402-10
3 Stamey TA, Caldwell M, McNeal JE, Nolley R, Hemenez M, Downs J. The prostate specific antigen era in the United States is over for prostate cancer: What happened in the last 20 years?. J Urol 2004; 172: 1297-301
4 Polascik TJ, Oesterling JE, Partin AW. Prostate specific antigen: A decade of discovery-what we have learned and where we are going. J Urol 1999; 162: 293-306
5 Sardana G, Dowell B, Diamandis EP. Emerging biomarkers for the diagnosis and prognosis of prostate cancer. ClinChem 2008; 54: 1951-60
6 Molinié V, Fromont G, Sibony M, Vieillefond A, Vassiliu V, Cochand-Priollet B. et al. Baglin. Diagnostic utility of a p63/alpha-methyl-CoA-racemase (p504s) cocktail in atypical foci in the prostate Mod Pathol 2004; 17: 1180-90
7 Hameed O, Sublett J, Humphrey PA. Immunohistochemical stains for p63 and alpha-methylacyl-CoA racemase, versus a cocktail comprising both, in the diagnosis of prostatic carcinoma: a comparison of the immunohistochemical staining of 430 foci in radical prostatectomy and needle biopsy tissues. Am J SurgPathol 2005; 29: 579-87
8 Sanderson SO, Sebo TJ, Murphy LM. et al. An analysis of the p63/ alpha-methylacyl coenzyme A racemaseimmunohistochemical cocktail stain in prostate needle biopsy specimens and tissue microarrays. Am J ClinPathol 2004; 121: 220-5
9 Browne TJ, Hirsch MS, Brodsky G, Welch WR, Loda MF, Rubin MA. Prospective evaluation of - AMACR (P504S) and basal cell markers in the assessment of routine prostate needle biopsy specimens. Hum Pathol 2004; 35: 1462-8
10 Jiang Z, Li C, Fischer A, Dresser K, Woda BA. Using an AMACR (P504S)/34betaE12/p63 cocktail for the detection of small focal prostate carcinoma in needle biopsy specimens. Am J ClinPathol 2005; 123: 231-6
11 Neto AS, Tobias-Machado M, Wroclawski ML. Molecular oncogenesis of prostate adenocarcinoma: role of the human epidermal growth factor receptor 2 (HER-2/neu). Tumori 2010; 96: 645-9
12 Baek KH, Hong ME, Jung YY. et al. Correlation of AR, EGFR, and HER-2 expression levels in prostate cancer: Immunohistochemical analysis and chromogenic in situ hybridization. Cancer Res Treat 2012; 44: 50-6
13 Montironi R, Mazzucchelli R, Barbisan F. HER-2 expression and gene amplification in pT2a Gleason score 6 prostate cancer incidentally detected in cyst prostatectomies: Comparison with clinically detected androgen-dependent and androgen-independent cancer. Hum Pathol 2006; 37: 1137-44
14 Ali NahitSendur M, Aksoy S, Ozdemir NY, Zengin N, Altundaǧ K. What is the mechanism of progression with Trastuzumab treatment - escape or resistance?. Asian Pac J Cancer Prev 2012; 13: 5915-6
15 Carrión-Salip D, Panosa C, Menendez JA. Androgen-independent prostate cancer cells circumvent EGFR inhibition by overexpression of alternative HER receptors and ligands. Int J Oncol 2012; 41: 1128-38
16 Gates JD, Carmichael MG, Benavides LC, Holmes JP, Hueman MT, Woll MM. Long term follow up assessment of a HER-2/neu peptide (E75) vaccine for prevention of recurrence in high-risk prostate cancer patients. J Coll Surg 2009; 208: 193-201
17 Qiu YQ, Leuschner I, Braun PN. Androgen receptor expression in clinically localized prostatecancer: Immunohistochemistry study and literature review. Asian J Androl 2008; 10: 855-63
18 Gleason DF, Mellinger GT. Prediction of prognosis for prostatic adenocarcinoma by combined histological grading and clinical staging. J Urol 1974; 11: 58-64
19 Allsbrook Jr WC, Mangold KA, Johnson MH, Lane RB, Lane CG, Amin B. et al. Interobserver reproducibility of Gleasons grading of prostatic carcinoma: Urologic pathologists. Hum Pathol 2001; 32: 74-80
20 Zahir ST, Tafti HF, Rahmani K. Overexpression of HER-2/neu in Patients with Prostatic Adenocarcinoma. Asian Pac J Cancer Prev 2014; 15: 6425-8
21 Iczkowski KA, Maclennan GT. Atypical small acinar proliferation suspicious for malignancy in prostate needle biopsies. Am J Surg Pathol 1997; 21: 1489-95
22 Algaba F, Epstein JI, Aldape HC, Farrow GM, Lopez-Beltran A, Maksem J. et al. Assessment of prostate carcinoma in core needle biopsy-definition of minimal criteria for the diagnosis of cancer in biopsy material. Cancer 1996; 78: 376-81
23 Goldstein NS, Underhill J, Roszka J, Neill JS. Cytokeratin 34 beta E-12 immunoreactivity in benign prostatic acini. Quantitation, pattern assessment, and electron microscopic study. Am J Clin Pathol 1999; 112: 69-74
24 Wojno KJ, Epstein JI. The utility of basal cell-specific anticytokeratin antibody (34 beta E12) in the diagnosis of prostate cancer. A review of 228 cases. Am J Surg Pathol 1995; 19: 251-60
25 Weinstein MH, Signoretti S, Loda M. Diagnostic utility of immunohistochemical staining for p63, a sensitive marker of prostatic basal cells. Mod Pathol 2002; 15: 1302-8
26 Zhou M, Chinnaiyan AM, Kleer CG, Lucas PC, Rubin MA. Alpha-MethylacylCoA racemase: A novel tumor marker over-expressed in several human cancers and their precursor lesions. Am J Surg Pathol 2002; 26: 926-31
27 Jiang Z, Woda BA, Rock KL, Xu Y, Savas L, Khan A. et al. P504S: A new molecular marker for the detection of prostate carcinoma. Am J Surg Pathol 2001; 25: 1397-140
28 Jiang Z, Wu CL, Woda BA, Dresser K, Xu J, Fanger GR. et al. P504S/alpha-methylacyl-CoA racemase: A useful marker for diagnosis of small foci of prostatic carcinoma on needle biopsy. Am J Surg Pathol 2002; 26: 1169-74
29 Jiang Z, Wu CL, Woda BA, Iczkowski KA, Chu PG, Tretiakova MS. et al. Alpha-methylacyl-CoA racemase: A multi-institutional study of a new prostate cancer marker. Histopathology 2004; 45: 218-25
30 Beach R, Gown AM, De Peralta-Venturina MN, Folpe AL, Yaziji H, Salles PG. et al. P504S immunohistochemical detection in 405 prostatic specimens including 376 18-gauge needle biopsies. Am J Surg Pathol 2002; 26: 1588-96
31 Magi-Galluzzi C, Luo J, Isaacs WB, Hicks JL, de Marzo AM, Epstein JI. Alpha-methylacylCoA racemase: A variably sensitive immunohistochemical marker for the diagnosis of small prostate cancer foci on needle biopsy. Am J Surg Pathol 2003; 27: 1128-33
32 Kunju LP, Rubin MA, Chinnaiyan AM, Shah RB. Diagnostic usefulness of monoclonal antibody P504S in the workup of atypical prostatic glandular proliferations. Am J Clin Pathol 2003; 120: 737-45
33 Takeda H, Akakura K, Masai M, Akimoto S, Yatani R, Shimazaki J. Androgen receptor content of prostate carcinoma cells estimated by immunohistochemistry is related to prognosis of patients with stage D2 prostate carcinoma. Cancer 1996; 77: 934-40
34 Segawa N, Mori I, Utsunomiya H, Nakamura M, Nakamura Y, Shan L. et al. Prognostic significance of neuroendocrine differentiation, proliferation activity and androgen receptor expression in prostate cancer. Pathol Int 2001; 51: 452-9
35 Inoue T, Segawa T, Shiraishi T, Yoshida T, Toda Y, Yamada T. et al. Androgen receptor, Ki67, and P53 expression in radical prostatectomy specimens predict treatment failure in Japanese population. Urology 2005; 66: 332-7
36 Li R, Wheeler T, Dai H, Frolov A, Thompson T, Ayala G. High level of androgen receptor is associated with aggressive clinicopathologic features and decreased biochemical recurrence-free survival in prostate. Am J Surg Pathol 2004; 28: 928-34
37 Bai Q, Chen F, Qi J. et al. Relationship between HER-2/ neu overexpression and androgen independent prostate cancer. Zhonghua Nan Ke Xue 2007; 13: 414-6
38 Neto AS, Tobias-Machado M, Wroclawski ML, Fonseca FL, Teixeira GK, Amarante RD. et al. Her-2/neu expression in prostate adenocarcinoma: A systematic review and meta-analysis. J Urol 2010; 184: 842-50
39 Siampanopoulou M, Galaktidou G, Dimasis N, Gotzamani- Psarrakou A. Profiling serum HER-2/NEU in prostate cancer. Hippokratia 2013; 17: 108-112