title: Ductal adenocarcinoma of the prostate: immunohistochemical findings and clinical significance.
abstract: BACKGROUND
  To investigate the clinical features, diagnosis, treatment, and prognosis of ductal adenocarcinoma of the prostate.
  
  
  METHODS
  The clinicopathological and immunohistochemical data of seven patients with ductal adenocarcinoma of the prostate were retrospectively analyzed. All patients underwent physical examination, magnetic resonance imaging (MRI), bone scan, cystoscopy, and computed tomography (CT) scan. The level of prostate-specific antigen (PSA) before and after surgery was assessed. Different prostate cancer markers were used for immunohistochemical staining.
  
  
  RESULTS
  The mean age of the seven patients diagnosed with prostatic ductal adenocarcinoma in this study was 76.2 years (range 57-88). Five patients presented with intermittent and painless gross hematuria, one patient with progressive dysuria, and one patient with elevated serum PSA on routine health examination. The level of PSA before surgery ranged from 1.3 to 45.0 ng/mL. Immunohistochemical staining results of the prostatic ductal adenocarcinoma confirmed positivity for PSA, prostatic acid phosphatase, androgen receptor, and alpha-methyacyl co-enzyme A (CoA)-reductase markers. Two of the patients underwent bilateral orchiectomy combined with anti-androgen therapy, three underwent transurethral resection of prostate, one received radical prostatectomy, and one received medical castration therapy. The clinical outcomes of all patients were satisfactory, based on follow-up data. The symptoms of hematuria and dysuria were ameliorated well, and the postoperative PSA level decreased below 4.0 ng/mL. Recurrence or metastasis of disease was not detected on MRI and bone scan.
  
  
  CONCLUSIONS
  Ductal adenocarcinoma of the prostate is a rare subtype of prostate carcinoma, the diagnosis of which could be based on pathological and immunohistochemical examination. Earlier management promises better prognosis.
authors.affiliation: Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, People's Republic of China ; School of Biomedical Engineering, Shanghai Jiaotong University, Shanghai, People's Republic of China.
authors.forename: Jianjun
authors.initials: J
authors.lastname: Sha
authors.forename: Juanjie
authors.initials: J
authors.lastname: Bo
authors.forename: Jiahua
authors.initials: J
authors.lastname: Pan
authors.forename: Lianhua
authors.initials: L
authors.lastname: Zhang
authors.forename: Hanqing
authors.initials: H
authors.lastname: Xuan
authors.forename: Wei
authors.initials: W
authors.lastname: Chen
authors.forename: Dong
authors.initials: D
authors.lastname: Li
authors.forename: Zhaoliang
authors.initials: Z
authors.lastname: Wang
authors.forename: Dongming
authors.initials: D
authors.lastname: Liu
authors.forename: Yiran
authors.initials: Y
authors.lastname: Huang
keywords: ductal adenocarcinoma; immunohistochemistry; pathology; prognosis; prostate