title: Utility of immunohistochemistry markers in the interpretation of post-high-intensive focussed ultrasound prostate biopsy cores.
abstract: OBJECTIVE
  To overcome the difficulties in the interpretation of postoperative tumor obtaining biopsy cores for patients who treated their prostate cancer with high-intensity focussed ultrasound (HIFU) therapy.
  
  
  METHODS
  The H&E slides of 58 patients with residual prostate cancer after HIFU treatment were systematically reviewed. Correlation between the pathologist's findings and immunohistochemical expression of MIB-1, alpha-Methyl-Co-Racemase and 34βE-12 staining was analyzed.
  
  
  RESULTS
  Mean time from treatment to biopsy was 40.2 (8-208) weeks. The expert review of the H&E slides identified 40 patients with viable carcinoma in the post-HIFU biopsy cores. 18 patients were revised to necrosis-only-tumors. These biopsies were performed not later than 16 weeks after HIFU treatment (median 10.9 weeks, range 8-14). Both MIB-1 and AMACR staining displayed significant differential expression in viable carcinoma (p < 0.001) compared to necrosis tumors. Referring to viable carcinoma tissue, AMACR staining index was significantly rising, the longer treatment dated back from biopsy (p < 0.002). In this context, 34-β-E12 stained negative through all tumor areas and positive in the majority (85%) of the surrounding non-neoplastic epithelium.
  
  
  CONCLUSIONS
  AMACR and MIB-1 reliably differentiate viable carcinoma from a process of ongoing irreversible necrosis in early post-HIFU prostate biopsy cores and therefore proposed-in addition with 34 beta-E12-as useful markers exposing suspicious tumor foci in difficult cases.
authors.affiliation: Department of Urology, University of Erlangen-Nuremberg, 91054, Erlangen, Germany, bernhard.walter@uk-erlangen.de.
authors.forename: B
authors.initials: B
authors.lastname: Walter
authors.forename: T
authors.initials: T
authors.lastname: Weiss
authors.forename: F
authors.initials: F
authors.lastname: Hofstädter
authors.forename: A
authors.initials: A
authors.lastname: Gaumann
authors.forename: A
authors.initials: A
authors.lastname: Hartmann
authors.forename: S
authors.initials: S
authors.lastname: Rogenhofer
authors.forename: R
authors.initials: R
authors.lastname: Ganzer
authors.forename: S
authors.initials: S
authors.lastname: Wach
authors.forename: D
authors.initials: D
authors.lastname: Engehausen
authors.forename: W F
authors.initials: WF
authors.lastname: Wieland
authors.forename: A
authors.initials: A
authors.lastname: Blana
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism; D062005:Biopsy, Large-Core Needle; D049109:Cell Proliferation; D015331:Cohort Studies; D003937:Diagnosis, Differential; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D007633:Keratins / Q000378:metabolism*; D019394:Ki-67 Antigen / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000378:metabolism* / Q000473:pathology; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D019998:Racemases and Epimerases / Q000378:metabolism*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014464:Ultrasonic Therapy
chemical_list: D014408:Biomarkers, Tumor; C121278:CK-34 beta E12; D019394:Ki-67 Antigen; D007633:Keratins; D019998:Racemases and Epimerases; C108352:alpha-methylacyl-CoA racemase