Prostate-specific antigen, high-molecular-weight cytokeratin (clone 34βE12), and/or p63: An optimal immunohistochemical panel to distinguish poorly differentiated prostate adenocarcinoma from urothelial carcinoma

Lakshmi P. Kunju, Rohit Mehra, Matthew Snyder, Rajal B. Shah

Research output: Contribution to journalArticlepeer-review

57 Scopus citations

Abstract

An optimal immunohistochemical panel to distinguish poorly differentiated prostate (PCa) from urothelial (UCa) carcinoma was selected from a panel consisting of prostate-specific antigen (PSA) and prostatic acid phosphatase (PAP), high-molecular-weight cytokeratin (HMWCK) (clone 34βE12), cytokeratin (CK) 7, CK20, p63, and α-methylacyl-coenzyme A racemase. The pilot group was composed of poorly differentiated UCa (n = 36) and PCa (n = 42). PSA and PAP stained 95% of PCa vs 0% and 11% of UCa cases, respectively. HMWCK and p63 stained 97% and 92% of UCa vs 2% and 0% of PCa cases respectively. CK7/CK20 coexpression was noted in 50% of UCa cases, whereas 86% of PCa cases were negative with both. A panel of PSA, HMWCK, andp63 was optimal for separating 95% PCa (PSA+/HMWCK and/or p63-) vs 97% UCa (PSA-/HMWCK and/or p63+). This panel was used on 26 diagnostically challenging cases and resolved 81% of cases as UCa vs PCa. The majority of PCa cases retain PSA. Negative PSA with positive HMWCK and/or p63 establishes a diagnosis of UCa.

Original languageEnglish (US)
Pages (from-to)675-681
Number of pages7
JournalAmerican journal of clinical pathology
Volume125
Issue number5
DOIs
StatePublished - May 2006
Externally publishedYes

Keywords

  • High-grade urothelial carcinoma
  • Immunohistochemistry
  • Poorly differentiated prostate adenocarcinoma

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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