Department of Pathology and Microbiology, Jordan University of Science and Technology, Irbid, Jordan.
J Clin Pathol. 2012 May;65(5):437-40. doi: 10.1136/jclinpath-2011-200533. Epub 2012 Jan 31.
Triple antibody cocktail immunohistochemical staining is routinely used as an ancillary method to establish a diagnosis of prostate cancer in biopsies with small foci of atypical glands. Crush artefact can distort surgical margins in radical prostatectomy specimens, occasionally making it difficult to diagnose a positive margin.
To investigate the ability of a cocktail stain to distinguish carcinoma from benign prostatic glands at the edge of crushed margins in prostatectomy specimens.
10 radical prostatectomy specimens with crushed benign glands at the surgical margins, and 20 with crushed margins positive for carcinoma were retrieved from the pathology archives. The latter included 16 (80%) with positive apical margins, 2 (10%) incised intraprostatic margins, and 1 (5%) soft tissue margin. Two-colour triple antibody stain using a cocktail of antibodies against α-methylacyl coenzyme A racemase (AMACR), high molecular weight keratin and p63 was performed on all the selected cases.
In 10/10 specimens with crushed benign glands, basal cell staining continued to be detectable, while AMACR staining was negative in all cases (0/10). In the positive margin cases, none of the crushed glands expressed basal cell marker staining (0/20), whereas 14/20 (70%) of the cases showed variable levels of AMACR positivity at the inked margin.
Two-colour triple antibody cocktail stain is useful in the assessment of most, but not all, surgical margins with crushed artefact in prostatectomy specimens by helping to establish whether glands are malignant or benign.
三抗体鸡尾酒免疫组织化学染色通常被用作辅助方法，以在活检中具有小灶性非典型腺体的情况下建立前列腺癌的诊断。压碎伪影会扭曲根治性前列腺切除术标本的手术切缘，偶尔会使阳性切缘的诊断变得困难。
研究鸡尾酒染色在前列腺切除标本压碎边缘处区分癌与良性前列腺腺体的能力。
从病理档案中检索了 10 例具有压碎良性腺体的边缘的根治性前列腺切除术标本，以及 20 例压碎边缘为癌的标本。后者包括 16 例（80%）为阳性顶切缘、2 例（10%）为切穿前列腺内切缘、1 例（5%）为软组织切缘。对所有选定的病例均进行了使用针对α-甲基酰基辅酶 A 消旋酶（AMACR）、高分子量角蛋白和 p63 的鸡尾酒双抗体染色。
在 10/10 例具有压碎良性腺体的标本中，基底细胞染色仍可检测到，而所有病例的 AMACR 染色均为阴性（0/10）。在阳性切缘病例中，没有一个压碎的腺体表达基底细胞标记物染色（0/20），而在 20 例中有 14 例（70%）在墨迹边缘显示出不同程度的 AMACR 阳性。
双色三抗体鸡尾酒染色在评估大多数但不是所有具有前列腺切除术标本压碎伪影的手术切缘时很有用，通过帮助确定腺体是恶性还是良性。
