Department of Pathology, Miraca Life Sciences, Irving, TX, USA.
Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA.
Histopathology. 2017 Jul;71(1):150-155. doi: 10.1111/his.13214. Epub 2017 Apr 26.
Patients who have undergone prostate radiation are at increased risk for developing urothelial carcinoma. Radiation changes can cause significant cytological atypia in benign prostate glands that may mimic pagetoid spread of urothelial carcinoma. GATA3 is a common marker for differentiating prostatic adenocarcinoma from urothelial carcinoma. The aim of this study was to investigate the expression of GATA3 in the epithelium of irradiated benign and malignant prostate tissue.
We performed a retrospective review of prostate cases with radiation atypia. GATA3 staining was performed on benign prostate tissue with and without radiation atypia, as well as on residual/recurrent prostatic adenocarcinoma after radiation therapy. PIN4 immunohistochemical (IHC) staining was performed on prostate tissue with radiation atypia to confirm the presence of both basal and luminal cells. We identified 31 cases with benign prostate glands containing radiation atypia. The average time between treatment with radiation therapy and the surgical procedure was 10 years (range 5-20 years). PIN4 IHC staining confirmed the presence of basal and luminal cells in benign prostate glands with radiation atypia. Thirty-one of 31 (100%) cases of benign prostate tissue with radiation atypia showed staining for GATA3 in both basal and luminal cells. Eight of eight (100%) cases of benign prostate glands without radiation atypia and no inflammatory changes showed GATA3 positivity limited to basal cells. GATA3 was negative in 12/12 (100%) cases of prostatic adenocarcinoma after radiation therapy.
Benign prostate glands with radiation atypia show diffuse positivity for GATA3. This staining pattern, along with the cytological atypia resulting from radiation, can mimic urothelial carcinoma.
接受前列腺放射治疗的患者发生尿路上皮癌的风险增加。放射改变可导致良性前列腺中出现明显的细胞学异型性，这可能类似于尿路上皮癌的 paget 样播散。GATA3 是鉴别前列腺腺癌与尿路上皮癌的常用标志物。本研究旨在探讨 GATA3 在放射治疗后良性和恶性前列腺组织上皮中的表达。
我们对具有放射异型性的前列腺病例进行了回顾性研究。对伴有和不伴有放射异型性的良性前列腺组织以及放射治疗后残留/复发的前列腺腺癌进行了 GATA3 染色。对具有放射异型性的前列腺组织进行 PIN4 免疫组化（IHC）染色，以确认存在基底细胞和腔细胞。我们共鉴定出 31 例具有放射异型性的良性前列腺腺体。放射治疗与手术之间的平均时间为 10 年（5-20 年）。PIN4 IHC 染色证实，具有放射异型性的良性前列腺腺体中存在基底细胞和腔细胞。31 例（100%）具有放射异型性的良性前列腺组织中，31 例（100%）均显示基底细胞和腔细胞中 GATA3 染色阳性。8 例（100%）无放射异型性和无炎症改变的良性前列腺腺体中，GATA3 阳性仅限于基底细胞。12 例（100%）放射治疗后的前列腺腺癌均为 GATA3 阴性。
具有放射异型性的良性前列腺腺体显示 GATA3 弥漫性阳性。这种染色模式，加上放射引起的细胞学异型性，可能类似于尿路上皮癌。
