Evaluation of the diagnostic value of immunohistochemistry staining for P63, Alpha-methyl Acyl-CoA Racemase, CK5/6, and 34βE12 in prostate carcinoma

Background: Prostate cancer is the most common male malignant tumor. Misdiagnosis in benign and malignant lesions of the prostate may lead to unnecessary or delayed treatment. Aim: The goal of this study was to determine the association between P63, 34βE12, CK5/6, and alpha-methyl acyl-CoA racemase (AMACR) biomarkers in a wide range of benign and malignant prostate tumors. Settings and Design: A total of 98 blocks of prostate tissue during the years 2006–2010 (in a single clinical center) were selected. Of these, 70 cases were malignant and 28 were benign. Subject and Methods: Immunohistochemistry (IHC) was done for P63, AMACR, CK5/6, and 34βE12 biomarkers. Chi-square and t-test were used for analyzing statically. Results: Of the 70 malignant specimens (prostate adenocarcinoma [PA]) stained by AMACR, 66 cases (94%) were positive. Of the 28 benign prostate samples, 27 cases (96%) were negative for AMACR. The sensitivity of the AMACR staining was 94% and its specificity was 96% in the diagnosis of adenocarcinoma of the prostate. The sensitivity of the biomarkers 34βE12 was 97% and its specificity was 100%. In the case of P63 and CK5/6, sensitivity and specificity were 98%, 96%, 98%, and 82%, respectively. Among basal cell biomarkers, 34βE12 had the highest specificity values. Conclusion: Due to the high sensitivity and specificity values of P63, AMACR, CK5/6, and 34βE12 biomarkers in the prostate lesions, the IHC method can be used for more reliable diagnosis and differentiation of benign and malignant types. By this approach, the possibility of pathologic diagnostic error between benign lesions and PA will be reduced.