Department of Pathology, Emory University School of Medicine, Atlanta, GA 30322, USA.
Pathology. 2012 Apr;44(3):199-203. doi: 10.1097/PAT.0b013e3283511c73.
To evaluate the utility of p63 and high molecular weight cytokeratin in the distinction between urothelial carcinoma with prostatic stromal invasion and urothelial carcinoma with colonisation of prostatic ducts and acini which may be challenging on H&E, especially for general pathologists who may occasionally encounter these cases.
A search of surgical pathology and consultation files was made for cystoprostatectomy specimens with confirmed urothelial carcinoma with prostatic stromal invasion. Intensity for both p63 and high molecular weight cytokeratin within the tumour cells were scored as negative/weak or strong.
A total of 34 cases were identified, 23 (68%) of which had associated foci of urothelial carcinoma with colonisation of prostatic ducts and acini. Mean patient age was 68.5 years (range 44-88 years). In all cases, basal cells of benign prostatic glands showed strong staining for both p63 and high molecular weight cytokeratin. Seventeen of 34 cases (50%) of urothelial carcinoma showed no or weak expression of high molecular weight cytokeratin in the tumour cells. The other 17 cases (50%) of urothelial carcinoma showed strong expression of high molecular weight cytokeratin in the tumour cells. Fourteen of 34 cases (41%) showed negative or weak expression of p63 in tumour cells. Twenty of 34 cases (59%) showed strong expression of p63 in tumour cells. In the 14 of 34 cases (41%) and 17 of 34 cases (50%) which showed negative/weak expression of p63 and high molecular weight cytokeratin, respectively, in the tumour cells, the positive staining of the basal cells by p63 and high molecular weight cytokeratin in the benign prostatic glands and acini or those colonised by urothelial carcinoma, aided in the distinction from urothelial carcinoma with prostatic stromal invasion. In the remaining 20 of 34 cases (59%) and 17 of 34 cases (50%) in which the tumour cells showed strong expression of p63 and high molecular weight cytokeratin, respectively, larger malignant tumour cells and smaller benign basal cells of the prostatic glands and acini were highlighted with these markers, and were easily distinguishable.
Our study suggests that p63 and high molecular weight cytokeratin may be utilised in the distinction between urothelial carcinoma with prostatic stromal invasion and urothelial carcinoma with colonisation of prostatic ducts and acini.
评估 p63 和高分子量细胞角蛋白在鉴别伴有前列腺基质浸润的尿路上皮癌与伴有前列腺导管和腺泡浸润的尿路上皮癌中的作用，这在 H&E 染色上可能具有挑战性，尤其是对于偶尔遇到这些病例的普通病理学家。
对经手术病理和会诊证实为伴有前列腺基质浸润的尿路上皮癌的膀胱前列腺切除术标本进行了检索。对肿瘤细胞内的 p63 和高分子量细胞角蛋白的强度进行评分，分为阴性/弱阳性或强阳性。
共确定了 34 例病例，其中 23 例（68%）伴有伴有前列腺导管和腺泡浸润的尿路上皮癌。患者平均年龄为 68.5 岁（范围 44-88 岁）。在所有病例中，良性前列腺腺泡的基底细胞均强烈表达 p63 和高分子量细胞角蛋白。34 例尿路上皮癌中有 17 例（50%）肿瘤细胞中不表达或弱表达高分子量细胞角蛋白。另外 17 例（50%）尿路上皮癌肿瘤细胞中强表达高分子量细胞角蛋白。34 例中有 14 例（41%）肿瘤细胞中 p63 表达阴性或弱阳性。34 例中有 20 例（59%）肿瘤细胞中 p63 强表达。在肿瘤细胞中分别出现 p63 和高分子量细胞角蛋白阴性/弱阳性表达的 14 例（41%）和 17 例（50%）病例中，良性前列腺腺泡和被尿路上皮癌浸润的腺泡中基底细胞的 p63 和高分子量细胞角蛋白的阳性染色有助于与伴有前列腺基质浸润的尿路上皮癌相区别。在肿瘤细胞中分别强表达 p63 和高分子量细胞角蛋白的 20 例（59%）和 17 例（50%）病例中，这些标志物突出显示了更大的恶性肿瘤细胞和较小的良性前列腺腺泡和腺基底细胞，易于区分。
我们的研究表明，p63 和高分子量细胞角蛋白可用于鉴别伴有前列腺基质浸润的尿路上皮癌与伴有前列腺导管和腺泡浸润的尿路上皮癌。
