Utility of PIN4 cocktail antibody in the atypical foci of the Prostate
Sujitha Chougani, Sunandalakshmi GV, Durga Kharidehal, Ravisankar V and Santhi Vissa
Diagnosis of prostatic carcinoma is based on histomorphological features. However, sometimes this can be challenging. In such situations immunohistochemistry can be a useful adjunct. This study is aimed to evaluate such suspicious or atypical cases by using PIN4 cocktail antibody (AMACR+p63+CK5/14).
Materials and methods: The present study was prospectively conducted at Upgraded Department of Pathology, Osmania general hospital, Hyderabad, Telangana state, India from August 2013 to July 2016. All hematoxylin and Eosin slides of prostatic specimens received during this period were routinely analyzed and cases with suspicious foci were subjected to immunohistochemistry. Immunohistochemistry was performed to look for expression of AMACR/p63/CK5/14 by using PIN4 Cocktail antibody.
Observation and results: Out of 306 prostatic specimens, 210 cases were Benign, 36 were malignant, 16 were PIN and 44 cases showed suspicious foci and these cases subjected to PIN4 cocktail antibody. Cases with p63+/CK5/14+/AMACR- were considered as benign, cases with p63-/CK5/14-/AMACR+ were considered as malignant, cases with p63+/CK5+/CK14+/AMACR+ were considered as Prostatic intraepithelial neoplasia (PIN)/Atypical adenomatous hyperplasia(AAH),cases with p63-/CK5/14-/AMACR- were considered as Atypical small acinar proliferation (ASAP).
Conclusion: Immunohistochemistry can be useful adjunct to biopsy. It reduces the chance of overdiagnosis of benign lesions as malignant, and under diagnosis of malignancies as benign. Also reduces the chances of unnecessary re-biopsy.