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Resumen Antecedentes: En el mundo, el carcinoma de próstata constituye la segunda causa de cáncer y la quinta causa de muerte por cáncer en hombres. Objetivo: Conocer el perfil inmunohistoquímico de la neoplasia intraepitelial prostática de alto grado y del adenocarcinoma acinar de próstata. Material y métodos: Estudio observacional, analítico, transversal y retrospectivo de especímenes obtenidos por biopsia con aguja cortante y resección de próstata debido a diagnóstico de adenocarcinoma acinar de próstata y neoplasia intraepitelial de alto grado, entre enero de 2015 y diciembre de 2020. Se realizaron microarreglos tisulares y, posteriormente, estudios de inmunohistoquímica para BCL2, EGFR, p53, Her2/neu y Ki67. Se realizó estadística descriptiva para analizar los factores clinicopatológicos; las variables cualitativas se compararon con prueba exacta de Fisher. Resultados: Se estudiaron 23 pacientes, ocho (34 %) con invasión angiolinfática, 14 (60.8 %) con invasión perineural, cinco (21.2 %) con prostatitis y cuatro (17.3 %) con hiperplasia fibroadenomatosa. Se observó expresión de HER2/neu (p = 0.1023), p53 (p = 1) y BCL2 (p = 0.4136). Conclusión: Se identificó mayor expresión de HER2/neu en la neoplasia intraepitelial prostática de alto grado y el adenocarcinoma acinar de próstata.
Abstract Background: Prostate carcinoma is the second leading cause of cancer and the fifth cause of cancer death in men worldwide. Objective: To know high-grade prostatic intraepithelial neoplasia and prostate acinar adenocarcinoma immunohistochemical profiles. Material and methods: Observational, analytical, cross-sectional, retrospective study of specimens obtained by cutting needle biopsy and prostate resection from subjects diagnosed with acinar adenocarcinoma of the prostate and high-grade prostatic intraepithelial neoplasia between January 2015 and December 2020. Tissue microarrays were performed and, subsequently, immunohistochemical studies for BCL2, EGFR, p53, Her2/neu and Ki67. Descriptive statistics were used to analyze clinicopathological factors. Qualitative variables were compared with Fisher's exact test. Results: Twenty-three patients were studied; eight (34%) with angiolymphatic invasion, 14 (60.8%) with perineural invasion, five (21.2%) with prostatitis, and four (17.3%) with fibroadenomatous hyperplasia. HER2/neu (p = 0.1023), p53 (p = 1) and BCL2 expression (p = 0.4136) was observed. Conclusion: HER2/neu increased expression was identified in high-grade prostatic intraepithelial neoplasia and acinar adenocarcinoma of the prostate.
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Objective: The present study was aimed at evaluating the contribution of transrectal prostate ultrasound in the screening for prostate neoplasias and in the guidance of prostate biopsies. Materials and Methods: Prospective study developed over a one-year period. All the patients with indication for prostate biopsy were evaluated. Regardless of PSA values, the patients underwent ultrasound in order to identify suspicious nodules (confirmed by two observers). Sextant biopsy was subsequently performed. In cases of finding suspicious nodules, an additional puncture directed to such nodules was done. Results: In a total of 155 cases the prevalence of malignancy was of 53%. Suspicious nodules were detected in 34 patients, and 25 where malignant (positive predictive value of 74%). The specificity and sensitivity for suspicious nodules were 88% and 31% respectively. Comparatively with the randomly obtained sextant specimens, the rate of findings of neoplasia was higher in the specimens obtained with puncture directed to the nodule (p = 0.032). No statistically significant difference was observed in the Gleason score for both types of specimens (p = 0.172). Conclusion: The high positive predictive value and the high rate of findings of neoplasia in specimens of suspicious nodules should be taken into consideration in the future. The authors suggest a biopsy technique similar to the one described in the present study (sextant biopsy plus puncture directed to the suspicious nodule). .
Objetivo: O objetivo deste estudo é avaliar o papel da ecografia prostática transretal no rastreamento da neoplasia prostática e na orientação da biópsia prostática. Materiais e Métodos: Estudo prospectivo com a duração de um ano. Foram avaliados todos os doentes com indicação para biópsia. Ignorando o valor de PSA, realizamos ecografia para identificar nódulos suspeitos (confirmados por dois observadores). Efetuamos, depois, biópsia dirigida a todos os sextantes. Nos casos com nódulo suspeito, efetuamos ainda punção adicional dirigida ao nódulo. Resultados: Num total de 155 casos, a prevalência de malignidade foi 53%. Detectamos nódulos suspeitos em 34 pacientes, 25 dos quais malignos (valor preditivo positivo de 74%). A especificidade e a sensibilidade dos nódulos suspeitos foram 88% e 31%, respectivamente. A porcentagem de tumor foi superior nas biópsias dirigidas ao nódulo, comparativamente à amostra com maior representação tumoral obtida aleatoriamente (p = 0,032). Não houve diferença estatisticamente significativa entre o escore de Gleason de ambas as amostras (p = 0,172). Conclusão: O elevado valor preditivo positivo e a elevada representação tumoral nos nódulos considerados suspeitos deverão ser levados em consideração no futuro. Sugerimos uma técnica de biópsia igual à utilizada neste estudo (biópsia sextante mais punção dirigida a nódulo suspeito). .
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Objective To evaluate the value of p504S,CK34?E12 and p63 immunostaining for the diagnosis of benign and malignant lesions of the prostate. Methods Expression of p504S、CK34?E12 and p63 in benign and malignant lesions of the prostate was observed by microwave SP immunohistochemical method. Results Continuous positive expression of CK34?E12 and p63 was found in the acini and ducts of most benign prostatic hyperplasia, and few cases showed interrupted expression, but p504S staining presented negative reaction; Interrupted expression of CK34?E12 and p63 was found in high prostatic intraepithelial neoplasia cases, and was weekly positive or negative for p504S; CK34?E12 and p63 staining was positive in five atypical adenomatous hyperplasia cases, one case presented focally positive reaction by p504S; CK34?E12 and p63 staining was negative in forty prostatic carcinoma, but positive by p504S;The gleason histologic grading of prostate carcinoma was negatively related to expression of p504S. Conclusion Combined detection of p504S、CK34?E12 and p63 can be most helpful for diagnosis of prostate carcinoma, especially in needle biopsy specimen.