Expression of prostatic acid phosphatase (PSAP) in transurethral resection specimens of the prostate is predictive of histopathologic tumor stage in subsequent radical prostatectomies.
Clinical management of incidental prostate cancer (IPC) remains challenging since its clinical course cannot be predicted by conventional histopathology. Aiming to define predictive factors in IPC, we correlated the immunohistochemically detected expression of prostate-specific antigen (PSA), prostatic acid phosphatase (PSAP), alpha-methylacyl-CoA racemase (AMACR, p504s), and androgen receptor in transurethral resection specimens with Gleason scores and histologic staging on the corresponding radicals in a cohort of 54 patients (mean age, 65.9 years; range, 49-80 years). PSAP expression showed a significant correlation with tumor staging (rho = -0.37; p = 0.02) but not with Gleason scores (rho = -0.06; p = 0.69). K-statistics revealed a highly significant moderate interobserver agreement concerning the evaluation of PSAP staining (K = 0.47; p < 0.001). In contrast, the other markers assessed failed to correlate with conventional histopathology. Therefore, PSAP might be predictive of tumor stage in IPC and represent a valuable adjunct for clinical decisions in terms of individual therapeutic management.
Gunia
Sven
S
Department of Pathology, HELIOS Clinic Bad Saarow, Charité-University Medicine Teaching Hospital, Pieskower Strasse 33, 15526, Bad Saarow, Germany. sven.gunia@helios-kliniken.de
Koch
Stefan
S
May
Matthias
M
Dietel
Manfred
M
Erbersdobler
Andreas
A
D000135:Acid Phosphatase; D000230:Adenocarcinoma / Q000175:diagnosis / Q000201:enzymology* / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism; D019085:Fluorescent Antibody Technique, Direct; D006801:Humans; D007124:Immunoenzyme Techniques; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D011467:Prostate / Q000201:enzymology* / Q000473:pathology / Q000601:surgery; D017430:Prostate-Specific Antigen / Q000378:metabolism; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000201:enzymology* / Q000601:surgery; D017027:Protein Tyrosine Phosphatases / Q000378:metabolism*; D019998:Racemases and Epimerases / Q000378:metabolism; D020728:Transurethral Resection of Prostate
D014408:Biomarkers, Tumor; D000135:Acid Phosphatase; C428439:prostatic acid phosphatase; D017027:Protein Tyrosine Phosphatases; D017430:Prostate-Specific Antigen; D019998:Racemases and Epimerases; C108352:alpha-methylacyl-CoA racemase