title: Utility of racemase and other immunomarkers in the detection of adenocarcinoma in prostatic tissue damaged by high intensity focused ultrasound therapy.
abstract: OBJECTIVE
  High intensity focused ultrasound (HIFU) is an emerging alternative for the treatment of prostate adenocarcinoma. Alpha-methylacyl-CoA racemase (AMACR) has been shown to be a sensitive immunomarker for prostate cancer, however, there is no information available concerning its utility and that of other immunomarkers for the detection of malignancy after HIFU therapy.
  
  
  METHODS
  AMACR expression was examined in 11 cases of prostatic carcinoma treated by HIFU, with histological evidence of residual carcinoma. In seven cases tumour was examined from thin core biopsies and in four cases from tissue fragments obtained by transurethral resection of prostate (TURP). In addition to AMACR, immunostaining was also undertaken for p63, cytokeratin 34betaE12, cytokeratin 5, cytokeratin 8-18, prostate specific alkaline phosphatase (PSAP), prostate specific antigen (PSA), chromogranin and CD56.
  
  
  RESULTS
  In two of the cases foci of tumour were cut out in serial sections. AMACR was expressed in eight of nine evaluable cases (4/5 biopsies and 4/4 TURP specimens). Cytokeratin 8-18 and PSAP were positive in all cases, whereas PSA was positive in five of nine cases. Cytokeratin 34betaE12, cytokeratin 5, and p63 marked the basal layer in normal prostatic glands, but were negative in neoplastic glands. In four cases we found tumour cells with positive staining for CD56 and chromogranin.
  
  
  CONCLUSIONS
  A panel with positive markers for AMACR, and negative markers for p63/cytokeratin 5/cytokeratin 34betaE12 confirms the neoplastic nature of the residual glands on biopsies or TURP fragments sampled after HIFU therapy.
authors.affiliation: Department of Pathology, Università di Verona, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Dalfior
authors.forename: Brett
authors.initials: B
authors.lastname: Delahunt
authors.forename: Matteo
authors.initials: M
authors.lastname: Brunelli
authors.forename: Alice
authors.initials: A
authors.lastname: Parisi
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Ficarra
authors.forename: Giacomo
authors.initials: G
authors.lastname: Novara
authors.forename: Giovanni
authors.initials: G
authors.lastname: Novella
authors.forename: Stefano
authors.initials: S
authors.lastname: Gobbo
authors.forename: Claudio
authors.initials: C
authors.lastname: Valotto
authors.forename: Marco
authors.initials: M
authors.lastname: Chilosi
authors.forename: Fabio
authors.initials: F
authors.lastname: Menestrina
authors.forename: Guido
authors.initials: G
authors.lastname: Martignoni
mesh_terms: D055011:Ablation Techniques / Q000379:methods; D000230:Adenocarcinoma / Q000201:enzymology* / Q000473:pathology / Q000628:therapy*; D014408:Biomarkers, Tumor / Q000378:metabolism*; D003131:Combined Modality Therapy; D019085:Fluorescent Antibody Technique, Direct; D006801:Humans; D007124:Immunoenzyme Techniques; D053555:Keratin-5 / Q000378:metabolism; D007633:Keratins / Q000378:metabolism; D008297:Male; D009336:Necrosis / Q000000981:diagnostic imaging / Q000473:pathology; D011471:Prostatic Neoplasms / Q000201:enzymology* / Q000473:pathology / Q000628:therapy*; D019998:Racemases and Epimerases / Q000378:metabolism*; D020728:Transurethral Resection of Prostate; D014464:Ultrasonic Therapy / Q000379:methods*; D014463:Ultrasonography
chemical_list: D014408:Biomarkers, Tumor; C121278:CK-34 beta E12; D053555:Keratin-5; D007633:Keratins; D019998:Racemases and Epimerases; C108352:alpha-methylacyl-CoA racemase