Cytoplasmic PTEN protein loss distinguishes intraductal carcinoma of the prostate from high-grade prostatic intraepithelial neoplasia

Intraductal carcinoma of the prostate is a marker of aggressive disease. However, intraductal carcinoma exists on a morphologic continuum with high-grade prostatic intraepithelial neoplasia (PIN) and distinguishing intraductal carcinoma from PIN is a common diagnostic dilemma with significant clinic...

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Bibliographic Details
Published in:Modern pathology 2013-04, Vol.26 (4), p.587-603
Main Authors: Lotan, Tamara L, Gumuskaya, Berrak, Rahimi, Hameed, Hicks, Jessica L, Iwata, Tsuyoshi, Robinson, Brian D, Epstein, Jonathan I, De Marzo, Angelo M
Format: Article
Language:English
Subjects:
692/699/67/1857
692/699/67/589/466
692/700/139
Biomarkers, Tumor - analysis
Biopsy
Cancer
Carcinoma, Ductal - diagnosis
Carcinoma, Ductal - metabolism
Cytoplasm - chemistry
Cytoplasm - metabolism
ERG
Humans
Immunohistochemistry
intraductal carcinoma
Laboratory Medicine
Male
Medicine
Medicine & Public Health
Neoplasm Grading
Neoplasm Staging
original-article
Pathology
Prostate
prostatic adenocarcinoma
Prostatic Intraepithelial Neoplasia - diagnosis
Prostatic Intraepithelial Neoplasia - metabolism
Prostatic Neoplasms - diagnosis
Prostatic Neoplasms - metabolism
Proteins
PTEN
PTEN Phosphohydrolase - analysis
PTEN Phosphohydrolase - metabolism
Tumors
Urology
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Summary:Intraductal carcinoma of the prostate is a marker of aggressive disease. However, intraductal carcinoma exists on a morphologic continuum with high-grade prostatic intraepithelial neoplasia (PIN) and distinguishing intraductal carcinoma from PIN is a common diagnostic dilemma with significant clinical implications. We evaluated whether immunostains for PTEN and ERG can sensitively identify intraductal carcinoma and accurately distinguish it from high-grade PIN. A combined immunostain for PTEN, ERG, p63 and CK903 was developed and validated. Radical prostatectomy specimens with lesions meeting criteria for intraductal carcinoma (n=45), intraductal cribriform proliferations falling short of intraductal carcinoma (n=15), and PIN lesions (n=39) were retrospectively identified and assessed for PTEN and ERG. Cytoplasmic PTEN loss was identified in 84% (38/45) of the intraductal carcinoma and 100% (15/15) of intraductal cribriform proliferation cases. In contrast, cytoplasmic PTEN loss was never observed in PIN (0/39; P95% and P
ISSN:0893-3952
1530-0285
DOI:10.1038/modpathol.2012.201