title: Aberrant expression of p63 in adenocarcinoma of the prostate: a radical prostatectomy study.
abstract: Prostatic adenocarcinoma with aberrant diffuse expression of p63 (p63-PCa) is a recently described variant of prostatic adenocarcinoma. The aim of this study was to investigate the clinical and pathologic features of p63-PCa at radical prostatectomy (RP). We reviewed 21 cases of p63-PCa diagnosed on needle biopsy at subsequent RP. Immunohistochemical analysis for PIN4 and Ki-67 was performed in all RP cases. p63-PCa showed a distinctive morphology consisting of atrophic, poorly formed glands, with multilayered and often spindled nuclei. Gleason grading was 3+3=6 in 28.5%, 3+5=8 in 38%, 3+4=7 in 14.3%, and 4+3=7, 5+3=8, and 5+4=9 in 9.5%. Usual-type acinar carcinoma coexisted in 85.7% with only p63-PCa present in the remaining cases. The usual-type carcinoma was Gleason grade 3+2=5 in 4.7%, 3+3=6 in 57%, 3+4=7 in 19%, and 4+3=7 in 4.3%. Overall, p63-PCa represented 65% of the total cancer volume (median 80%). The tumor was organ-confined in 16 cases (76.2%). In the remaining 5 cases, 2 had p63-PCa extending to the margin in areas of intraprostatic incisions, 2 had usual-type acinar adenocarcinoma extending to the margin and extraprostatic tissue, respectively, and 1 had p63-PCa with an unusual cribriform morphology involving the bladder neck. Ki-67 was low, <5% in all cases of p63-PCa, with similar expression in the coexisting acinar-type carcinoma. In summary, it is recommended that these tumors not be assigned a Gleason score and their favorable findings at RP be noted.
authors.affiliation: *Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN Departments of †Pathology ‡Urology §Oncology, The Johns Hopkins Medical Institutions, Baltimore, MD.
authors.forename: Giovanna A
authors.initials: GA
authors.lastname: Giannico
authors.forename: Hillary M
authors.initials: HM
authors.lastname: Ross
authors.forename: Tamara
authors.initials: T
authors.lastname: Lotan
authors.forename: Jonathan I
authors.initials: JI
authors.lastname: Epstein
mesh_terms: D000230:Adenocarcinoma / Q000737:chemistry* / Q000473:pathology / Q000601:surgery*; D000368:Aged; D001707:Biopsy, Needle; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000032:analysis; D008297:Male; D008875:Middle Aged; D000072340:NIMA-Interacting Peptidylprolyl Isomerase; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D019696:Peptidylprolyl Isomerase / Q000032:analysis; D011237:Predictive Value of Tests; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000737:chemistry* / Q000473:pathology / Q000601:surgery*; D014157:Transcription Factors / Q000032:analysis*; D025521:Tumor Suppressor Proteins / Q000032:analysis*
chemical_list: D019394:Ki-67 Antigen; D000072340:NIMA-Interacting Peptidylprolyl Isomerase; C115051:TP63 protein, human; D014157:Transcription Factors; D025521:Tumor Suppressor Proteins; C000606846:PIN1 protein, human; C000606848:PIN4 protein, human; D019696:Peptidylprolyl Isomerase