title: Evaluation of contemporary prostate and urothelial lineage biomarkers in a consecutive cohort of poorly differentiated bladder neck carcinomas.
abstract: OBJECTIVE
  New immunohistochemical (IHC) markers of urothelial carcinoma (UCa) and prostatic adenocarcinoma (PCa) have emerged in recent years, yet comparative studies to establish markers remain lacking. We aimed to identify an effective but parsimonious approach for poorly differentiated bladder neck lesions, to establish a best practice panel approach in a setting simulating prospective use.
  
  
  METHODS
  We tested the performance of a panel of IHC markers on whole sections of a consecutive cohort of transurethral resection specimens of poorly differentiated, challenging bladder neck resections (n=36).
  
  
  RESULTS
  In the setting of poorly differentiated bladder neck carcinomas, biomarker sensitivities for UCa were as follows: GATA3, 100%; S100P, 88%; p63, 75%; and cytokeratin (CK) 5/6, 56%; specificities of each were 100%. CK7 and CK20 showed sensitivities of 75% and 63%, though these were only 85% and 80% specific. For PCa markers, NKX3.1, p501S, prostate-specific membrane antigen, and androgen receptor (AR) each showed 100% sensitivity, outperforming ERG (35%) and prostate-specific antigen (PSA; 25%). All the prostate histogenesis markers were 100% specific, except for AR, which was positive in 13% of the UCa cases.
  
  
  CONCLUSIONS
  Novel IHC markers show improved diagnostic performance that enables positive and negative support for identifying histogenesis with the use of as few as two markers for this critical therapeutic distinction. PSA underperforms newer markers.
authors.affiliation: From the Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, and.
authors.forename: Sambit K
authors.initials: SK
authors.lastname: Mohanty
authors.affiliation: From the Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, and.
authors.forename: Steven C
authors.initials: SC
authors.lastname: Smith
authors.affiliation: From the Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, and.
authors.forename: Elena
authors.initials: E
authors.lastname: Chang
authors.affiliation: From the Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, and.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Luthringer
authors.affiliation: PhenoPath Laboratories, Seattle, WA.
authors.forename: Allen M
authors.initials: AM
authors.lastname: Gown
authors.affiliation: From the Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, and.
authors.forename: Manju
authors.initials: M
authors.lastname: Aron
authors.affiliation: From the Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, and aminm@cshs.org.
authors.forename: Mahul B
authors.initials: MB
authors.lastname: Amin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000276:immunology / Q000378:metabolism*; D002454:Cell Differentiation; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011467:Prostate / Q000378:metabolism* / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000378:metabolism; D011944:Receptors, Androgen; D001743:Urinary Bladder / Q000378:metabolism* / Q000473:pathology; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis / Q000378:metabolism* / Q000473:pathology*
chemical_list: D014408:Biomarkers, Tumor; D011944:Receptors, Androgen; D017430:Prostate-Specific Antigen
keywords: AR; Bladder neck; ERG; GATA3; Immunohistochemistry; NKX3.1; PSMA; Prostatic adenocarcinoma; S100P; Urothelial carcinoma; p501S