title: Diagnostic utility of a p63/alpha-methyl coenzyme A racemase (p504s) cocktail in ambiguous lesions of the prostate upon needle biopsy.
abstract: OBJECTIVE
  To investigate the potential utility of a new combined immunostaining technique for diagnosing prostate cancer from histological analysis of needle biopsy specimens.
  
  
  METHODS
  Tissue was immunostained with a combination of antibodies against a basal cell marker (p63), and an enzyme commonly overexpressed in prostate cancer (p504s), on 63 small prostate cancer foci (<1 mm) and 109 cases of ambiguous lesions observed in needle biopsies.
  
  
  RESULTS
  After p63/p504s immunostaining, 93% of the ambiguous lesions (102/109) were classified. The final diagnoses retained were: 92 prostate cancers, seven atypical small acinar proliferations suspected of being malignant but undiagnosed, 21 prostatic intraepithelial neoplasia, five atypical adenomatous hyperplasia, and 36 atrophic benign mimickers of cancer.
  
  
  CONCLUSIONS
  Combining p504s as a positive marker for prostate cancer and p63 as a negative marker might improve diagnostic performance, sensitivity and specificity, and lead to fewer false-negative results. This simple immunostaining procedure should reduce the percentage of residual ambiguous lesions and the need for additional biopsies.
authors.affiliation: Department of Pathology, Hôpital Saint-Joseph, Paris, France. vmolinie@hopital-saint-joseph.org
authors.forename: Vincent
authors.initials: V
authors.lastname: Molinié
authors.forename: Jean Marie
authors.initials: JM
authors.lastname: Hervé
authors.forename: Pierre Marie
authors.initials: PM
authors.lastname: Lugagne
authors.forename: Thierry
authors.initials: T
authors.lastname: Lebret
authors.forename: Henry
authors.initials: H
authors.lastname: Botto
mesh_terms: D000906:Antibodies / Q000378:metabolism; D001707:Biopsy, Needle / Q000379:methods; D002471:Cell Transformation, Neoplastic; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D008297:Male; D008565:Membrane Proteins / Q000378:metabolism; D011467:Prostate / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000473:pathology*; D019998:Racemases and Epimerases; D012680:Sensitivity and Specificity
chemical_list: D000906:Antibodies; C081876:CKAP4 protein, human; D008565:Membrane Proteins; D019998:Racemases and Epimerases; C108352:alpha-methylacyl-CoA racemase