Prostate Adenocarcinoma
IHC Expression Characteristics
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Negative
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Typically negative, rarely positive.
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Racemase enzyme expressed by high grade PIN and Prostate adencoarcinoma (NOT a specific marker for prostate tissue). Relatively good specificity (~90%), but may mark benign prostate lesions. Often used in a cocktail with p63 and HMWKs (e.g. PIN4)
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>95% sensitivity for prostate adenocarcinoma (highly specific)
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PSAP
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Earlier marker than PSA (now used occasionally as a backup) with less specificity compared to PSA
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Combination stain containing a cocktail of AMACR (red), p63, and high molecular weight cytokeratins (CK5 & CK14)
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34BetaE12
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HMWK that is often used to highlight the basal layer of prostate glands (positivity means it is not invasive adenocarcinoma).
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HMWK which has similar characteristics as 34betaE12
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Nuclear marker which highlights the basal layer of benign prostate glands.
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Prostatic Duct Carcinoma
IHC expression is the same as prostate adenocarcinoma. Morphology is similar to breast DCIS. Sometimes it may be confused with a primary colon adenocarcinoma (CDX-2+) or a primary urothelial carcinoma (PSA=).
References
Diagnostic Immunohistochemistry: Theranostic and Genomic Applications. [edited by] DJ Dabbs. 3rd Edition. Elsevier, 2010.