Aberrant Expression of p63 in Adenocarcinoma of the Prostate A Radical Prostatectomy Study

作者：Giannico Giovanna A; Ross Hillary M; Lotan Tamara; Epstein Jonathan I^*

来源：American Journal of Surgical Pathology, 2013, 37(9): 1401-1406.

• p63
• radical prostatectomy
• prostate cancer

Prostatic adenocarcinoma with aberrant diffuse expression of p63 (p63-PCa) is a recently described variant of prostatic adenocarcinoma. The aim of this study was to investigate the clinical and pathologic features of p63-PCa at radical prostatectomy (RP). We reviewed 21 cases of p63-PCa diagnosed on needle biopsy at subsequent RP. Immunohistochemical analysis for PIN4 and Ki-67 was performed in all RP cases. p63-PCa showed a distinctive morphology consisting of atrophic, poorly formed glands, with multilayered and often spindled nuclei. Gleason grading was 3 + 3 = 6 in 28.5%, 3+ 5 = 8 in 38%, 3 vertical bar 4 = 7 in 14.3%, and 4 vertical bar 3 = 7, 5 vertical bar 3 = 8, and 5 vertical bar 4 = 9 in 9.5%. Usual-type acinar carcinoma coexisted in 85.7% with only p63-PCa present in the remaining cases. The usual-type carcinoma was Gleason grade 3 + 2 = 5 in 4.7%, 3+ 3= 6 in 57%, 3+ 4 = 7 in 19%, and 4+ 3= 7 in 4.3%. Overall, p63-PCa represented 65% of the total cancer volume (median 80%). The tumor was organ-confined in 16 cases (76.2%). In the remaining 5 cases, 2 had p63-PCa extending to the margin in areas of intraprostatic incisions, 2 had usual-type acinar adenocarcinoma extending to the margin and extraprostatic tissue, respectively, and 1 had p63-PCa with an unusual cribriform morphology involving the bladder neck. Ki-67 was low, < 5% in all cases of p63-PCa, with similar expression in the coexisting acinar-type carcinoma. In summary, it is recommended that these tumors not be assigned a Gleason score and their favorable findings at RP be noted.

• 出版日期2013-9