Diagnostic Efficacy of ERG and CK5 Coexpression in Prostatic Intraepithelial Neoplasia and Carcinoma

Title: Diagnostic Efficacy of ERG and CK5 Coexpression in Prostatic Intraepithelial Neoplasia and Carcinoma

Authors: Dr Madhu Kumar, Dr Piyush Sagar, Prof Suresh Babu, Prof S N Shankwar, Prof Nushat Hussain

DOI: https://dx.doi.org/10.18535/jmscr/v4i12.29

Abstract

Background: Prostate lesions either benign, Premalignant or malignant, continues to be distressing and annoying problem for old people from centuries. Carcinoma of prostate is most common internal malignancy among men & is responsible for 10% of cancer death in the population. The combination of ERG and CK5 provides a unique stain that identifies the TMPRSS2-ERG chromosomal translocation in prostate cancer. The current study aims to detect the diagnostic efficacy of ERG & CK5 co-expression in BPH, PIN & Prostatic carcinoma.

Aims & Objectives: Study of coexpression of ERG & CK5 immunohistochemical stain in BPH, PIN and Prostatic carcinoma and to correlate with serum PSA level, tumor stage and grade.

Materials & Methods: We received TURP and Tru-cut biopsy specimen for histopathological examination. Specimens were processed, sections cut, stained with Hematoxylin & Eosin as well as apply cocktail of ERG & CK5 immunohistochemical stain as per standard protocol.

Results & Discussion: On the basis of histology, 11 cases were Benign Prostatic Hyperplasia (37%), 9 cases were Benign Prostatic Hyperplasia with Prostatic Intraepithelial Neoplasia (30%) and 10 cases (33%) were prostatic carcinoma.

Sensitivity and specificity of ERG&CK5 immunostain in detecting ERG positive prostatic adenocarcinoma being 70% and 100% respectively in our study. Thus staining for ERG&CK5 has great utility in resolving diagnostic problems of PIN and adenocarcinoma prostate cases that arises in prostatic needle biopsies containing small foci of suspicious cells.

Conclusion: However immunohistochemical stain is an important adjunct to the diagnosis and predictive analysis of prostate biopsy specimens.

Keywords: Immunohistochemical stain, ERG, CK5, TURP & Tru-cut biopsy of Prostate.

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Corresponding Author

Dr Madhu Kumar

Associate Professor, Department of Pathology,

King George’s Medical University, Lucknow UP 226003

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