title: Usefulness of cytokeratin 5/6 and AMACR applied as double sequential immunostains for diagnostic assessment of problematic prostate specimens.
abstract: We evaluated the usefulness of double immunohistochemical staining for cytokeratin (CK)5/6 and alpha-methylacyl coenzyme A racemase (AMACR) applied sequentially on 1 slide by assessing 223 foci in 110 consecutive prostate specimens. Double-chromogen reaction was used to visualize the antibodies: brown for CK5/6 and red for AMACR. Staining was scored as diffuse, focal, or negative. To establish the diagnosis, CK5/6 and AMACR were correlated with the morphologic features. All cancers lacked CK5/6 staining (100% specificity). AMACR showed diffuse or focal positivity in cancer, high-grade prostatic intraepithelial neoplasia, and atypia in 96.8% (120/124), 85% (22/26), and 80% (16/20) of cases, respectively. In atypical cases, diagnosis was because of non-immunohistochemical staining reasons in 80% of cases. In adenosis (n = 14), AMACR was diffusely positive in 4 cases (29%). Double immunohistochemical staining for CK5/6 and AMACR is a simple assay to perform and may be used as an alternative to antibody cocktails for routine evaluation of problematic prostate specimens.
authors: Anatomical Pathology, Rockyview General Hospital, Department of Pathology and Laboratory Medicine, Calgary Laboratory Services and University of Calgary, 7007 - 14 Street SW, Calgary, Alberta T2V 1P9, Canada.
authors: Kiril
authors: K
authors: Trpkov
authors: Joanna
authors: J
authors: Bartczak-McKay
authors: Asli
authors: A
authors: Yilmaz
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D053555:Keratin-5 / Q000378:metabolism*; D053553:Keratin-6 / Q000378:metabolism*; D008297:Male; D011471:Prostatic Neoplasms / Q000378:metabolism*; D019998:Racemases and Epimerases / Q000378:metabolism*; D012680:Sensitivity and Specificity; D013194:Staining and Labeling / Q000379:methods*
chemical_list: D014408:Biomarkers, Tumor; D053555:Keratin-5; D053553:Keratin-6; D019998:Racemases and Epimerases; C108352:alpha-methylacyl-CoA racemase