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Using an AMACR (P504S)/34βE12/p63 Cocktail for the Detection of Small Focal Prostate Carcinoma in Needle Biopsy Specimens

Zhong Jiang MD, Cuizhen Li MD, PhD, Andrew Fischer MD, Karen Dresser, Bruce A. Woda MD
DOI: http://dx.doi.org/10.1309/1G1NK9DBGFNB792L 231-236 First published online: 1 February 2005


We assessed the usefulness of immunohistochemical analysis with a 3-antibody cocktail (α-methylacyl coenzyme A racemase [AMACR, or P504S], 34βE12, p63) and a double-chromogen reaction for detection of limited prostate cancer in 138 needle biopsy specimens, including 82 with small foci of prostatic adenocarcinoma and 56 benign prostates. When carcinoma was present, red cytoplasmic granular staining (AMACR) in the malignant glands and cells and dark brown nuclear (p63) and cytoplasmic (34βE12) staining in basal cells of adjacent nonmalignant glands were found. Of 82 cases of small foci of prostatic adenocarcinoma, 78 (95%) expressed AMACR; all malignant glands were negative for basal cell staining. All benign glands adjacent to malignant glands were recognized easily by basal cell marker positivity and little or no AMACR expression. No benign glands were simultaneously positive for AMACR and negative for basal cell markers (specificity, 100%). There were no differences in intensity and numbers of positive glands with double-chromogen staining compared with using 1-color staining. Our results indicate that immunohistochemistry with a 3-antibody cocktail and double chromogen is a simple and easy assay that can be used as a routine test, which overcomes the problems of studying small lesions in prostate needle biopsies with multiple immunohistochemical stains.

Key Words:
  • α-Methylacyl-CoA racemase
  • P504S
  • 34βE12
  • p63
  • Prostate carcinoma
  • Immunohistochemistry
  • Antibody cocktail
  • Double color