Intraductal Prostate Carcinoma an Aggressive Variant . Histopathological Analysis and Evaluation of the Correlation with erg and p 63 Article Information

Objective: Intraductal Carcinoma of the prostate (IDC-P) is a malignant lesion characterized by an expansive proliferation of malignant prostatic epithelial cells within ducts and acini. TMPRSS2-ERG is the most common ERG gene fusion in prostate cancer, and represents an early event in prostate cancer progression in particular as regard IDC-P. P63 is a homologue of the p53 tumor suppressor gene. We evaluated the presence of IDC-P and its putative correlation with other pathologic features, including ERG and p63 expression. Method: The series consisted of 79 prostate cancer cases. IDC-P was classified on hematoxylin and eosin-stained. Two unstained tissue sections were collected for IHC, staining with anti-p63 and TMPRSS2ERG. Results: ERG expression was seen in 43.03% (34/79): it was widely positive, with negative immunostaining for p63, in the intraductal component of 12 /13 (92.3%) in the high grade cases with relapse, of 18/29 (62%) in the high grade group within relapse, and of 4/7 (57.15%) in the low grade group with relapse. In our study, IDC–P and high ERG expression was associated with aggressive disease (higher Gleason grade, pathologic stage and preoperative PSA) and adverse clinical outcomes (biochemical and disease recurrence). Conclusions: ERG over expression in IDC-P was much more common in peripheral zone prostate cancers than in the transitional zone. In our hands, ERG immune positivity was related either to aggressive local tumor characteristics or to a worse outcome. Further studies will be required to identify the subgroup of prostate cancers in which TMPRSS2/ERG fusion may be prognostically important. Introduction Intraductal Carcinoma of the prostate (IDC-P) is a malignant le sion characterized by an expansive proliferation of malignant prostatic secretory epithelial cells within prostatic ducts and acini and demonstrates significant architectural and cytologi cal atypia [1]. The presence of IDC-P in a specimen is frequently associated with large tumor volume, advanced disease stage, high Gleason score, and increased risk of recurrence [2]. The diag nostic criteria and clinical significance of this entity continue to evolve as more studies are undertaken, and advances Intraductal Prostate Carcinoma an Aggressive Variant. Histopathological Analysis and Evaluation of the Correlation with erg and p63 Article Information Received date: Jan 18, 2019 Accepted date: Jan 26, 2019 Published date: Feb 05, 2019 Pinuccia Faviana1, Riccardo Bartoletti2, Marco Panichi2, Francesca Manassero2, Fabiola Farci1, Annamaria Bartolucci1, Simona Ortori2, Luca Galli3, Ramona Baldesi2, Cesare Selli2 and Laura Boldrini1 1Department of Surgical, Medical, Molecular Pathology and Critical Area, University of Pisa, Italy 2Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy 3Department of Oncology, Azienda Ospedaliero-Universitaria Pisana and University of Pisa, Italy *Corresponding author Pinuccia Faviana, Department of Surgical, Medical, Molecular Pathology and Critical Area, University of Pisa, Via Roma 57, 56126 Pisa, Italy