Movember 2024

Immunohistochemical (IHC) diagnostics play an important role in the diagnosis of prostate cancer, particularly in differentiating between benign and malignant prostate diseases and in determining the type of tumor. Prostate cancer is the most common cancer in men in Germany, accounting for 26% of all cancers (Robert Koch Institute brochure: Krebs in Deutschland für 2019/2020 (PDF, 14 MB)).). Around 70,000 new cases are diagnosed every year. The risk of developing prostate cancer increases with age. Most diagnoses are made in men over the age of 65. The prognosis is generally good, especially if the cancer is detected early. The 5-year survival rate is over 90% in the early stages. The  “S3 Leitlinie Prostatakrebs” (V07, 31.05.2024)  (https://www.leitlinienprogramm-onkologie.de/leitlinien/prostatakarzinom) recommends the following markers for diagnosis:

• p63, CK5/6, CK34bE12 (immunohistochemical staining with basal cell markers): To detect the absence of basal cells in unclear cases and in cases where the grade of a lesion cannot be clearly determined using conventional morphological methods

• Alpha-methylacyl-CoA racemase (AMACR): As a "molecular neoplasia marker" for prostate carcinoma in the diagnosis of difficult cases

• PSA, Prostein, NKX3.1, ERG, PSP, SPP, androgen receptor: proof of origin from the prostate

  and recommends for differential diagnosis:

• Colon CK20+/CK7-/CDX2+

• Urothelium CK7(+) and CK20(+), GATA3+, Uroplakin 2+, p63+

Combined detection of P504S and p63 is very useful for the diagnosis of small prostate cancers in needle biopsies or HGPIN. Anti-P504S antibody stains positive and granular in cytoplasm of malignant and pre-malignant prostate glands whereas anti-p63 antibody stains positive in nuclei of benign glands.

Staining algorithm for differentiation from colon carcinoma / urothelial carcinoma

according to "Quick Reference Handbook for Surgical Pathologists - Rekhtman N et al."

You can find CE/IVD certified antibodies for your prostate cancer diagnostics at Zytomed Systems https://www.zytomed-systems.de/produkte/immunhistologie/antikoerper.