A study to correlate histopathology, biochemical marker and immunohistochemical expression of sex-steroid receptors in prostatic growth

Abstract

Prostate gland is a fibromusculoglandular structure situated at the neck of urinary bladder. So, enlargement or growth of prostate due to nodular hyperplasia (NHP) or prostatic intraepithelial neoplasia (PIN) or adenocarcinoma may give rise to bladder outlet obstruction. Malignant growth i.e., PIN or adenocarcinoma cases are associated with increased blood level of prostate-specific antigen (PSA) and increased expression of different sex-steroid receptors because the growth is dependent on the interactions of androgen, progesterone and estrogen. The aim of our study is to correlate the histopathology, PSA levels and expression of different sex-steroid receptors by immunohistochemistry in different prostatic growth lesions. Among the total 50 cases received, inclusive of transurethral resection of prostate (TURP), transrectal ultrasound-guided biopsy and radical prostatectomy, 34 cases were diagnosed as NHP, 4 cases as PIN and 12 cases as adenocarcinoma histopathologically. Serum PSA values above 10 ng/ml were seen in 2 cases of PIN and 11 cases of adenocarcinoma and none of NHP. Estrogen receptor (ER) () expressions were negative in all cases. Progesterone receptor (PR) expressions were strongly positive in 35% cases of both NHP and adenocarcinoma, whereas androgen receptor (AR) expressions were strong among all cases of adenocarcinoma and only in four cases of NHP. By observing these findings it can be suggested that antiandrogen and antiprogesterone therapy simultaneously will do better than antiandrogen alone in treating prostatic growth lesions.

Immunohistochemistry analysis of estrogen receptor and androgen receptor in benign prostatic hyperplasia and prostate carcinoma

“…However Naskar S et al showed negative ER expression in prostate tissues and was negative in all cases of BPH and prostate carcinoma. 11 These IHC results were identical to that of other studies such as Wernert et al Where they found the ER was demonstrated in nuclei of periglandular fibrocytes, smooth muscle cells and hyperplatic basal cells, but glandular secretory epithelium were negative in prostatic carcinoma cases. 25 Immunohistochemically Androgen Receptor (AR) analysis was done on 30 malignant cases of prostate and 35 benign cases.…”

“…These findings were supported by study done by Hameed S et al and Mansoor I et al 9,10 Aslam HM et al stated that frequency of hyperplasia increases with age from fifth decade to seventh decade, this reflects that hyperplasia may be a normal aging process. 7 According to the study by Naskar S et al mean age of presentation for prostatic lesions were 68.66 years 11 which was analogous to our study. There were no significant age differences detected between the benign and malignant cases as stated by Men S et al, our study was also in concordance with the study conducted by Men S et al where the mean age distribution for prostatic lesions is 64.67 years.…”

“…Only 11.78% of BPH cases, 50% of PIN cases and 100% of carcinoma cases showed strongly positive AR expression. 11 When the correlation between ER and AR in malignant and benign cases were assessed it was found that there was no correlation seen in malignant cases, however strong correlation was seen between AR and ER staining in benign cases. This correlation states that both androgen and estrogen receptors plays a crucial role in the progression of BPH.…”

Incidental Detection of Prostate Cancer in Transurethral Resection of Prostate (Turp) Specimens: A Retrospective Study.

“…Prostate is a fibro-musculo-glandular organ encircling the neck of the urinary bladder. So, enlargement or growth of prostate due to nodular hyper plasia or prostatic intraepithelial neoplasia or adenocarcinoma may give rise to bladder outlet obstruction (2).…”