CK5, CK5/6, and double-stains CK7/CK5 and p53/CK5 discriminate in situ vs invasive urothelial cancer in the prostate

Am J Clin Pathol. 2012 Aug;138(2):190-7. doi: 10.1309/AJCP5ZC4GQVNWTYR.

Abstract

For primary bladder tumors, distinguishing urothelial carcinoma (UC) invading the fibromuscular stroma of the prostate (pT4a) from in situ UC involving prostatic ducts can be difficult. Immunohistochemical markers (cytokeratin [CK]5/6, CK5, CK7, CK20, p53, p63, high-molecular-weight keratin [HMWK], androgen receptor, prostate-specific antigen [PSA], prostate specific acid phosphatase [PSAP], laminin, CD44s, CD141) were assessed for their usefulness in determining depth of UC invasion in the prostate. In cystoprostatectomy specimens containing in situ UC in prostatic ducts, both CK5/6 and CK5 clearly differentiated prostatic basal cells from in situ UC. The remaining markers were not effective in determining depth of tumor invasion. Double-stain combinations CK7/CK5 and p53/CK5 were performed and robustly color contrasted in situ tumor from surrounding basal cells. The use of CK5/6, CK5, CK7/CK5, or p53/CK5 is recommended to assist in determining the depth of UC invasion in the prostate when histologic findings are equivocal.

MeSH terms

  • Acid Phosphatase / analysis
  • Biomarkers, Tumor / analysis*
  • Carcinoma in Situ / chemistry*
  • Carcinoma in Situ / pathology*
  • Humans
  • Hyaluronan Receptors / analysis
  • Keratin-20 / analysis
  • Keratin-5 / analysis
  • Keratin-6 / analysis
  • Keratin-7 / analysis
  • Laminin / analysis
  • Male
  • Neoplasm Invasiveness / pathology
  • Neoplasm Staging
  • Prostate-Specific Antigen / analysis
  • Prostatic Neoplasms / chemistry*
  • Prostatic Neoplasms / pathology*
  • Tumor Suppressor Protein p53 / analysis
  • Urinary Bladder Neoplasms / chemistry*
  • Urinary Bladder Neoplasms / pathology*
  • Urothelium / chemistry
  • Urothelium / pathology

Substances

  • Biomarkers, Tumor
  • CD44 protein, human
  • Hyaluronan Receptors
  • Keratin-20
  • Keratin-5
  • Keratin-6
  • Keratin-7
  • Laminin
  • Tumor Suppressor Protein p53
  • Acid Phosphatase
  • Prostate-Specific Antigen