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New and Emerging Diagnostic and Prognostic Immunohistochemical Biomarkers in Prostate Pathology

Giannico, Giovanna A. MD; Arnold, Shanna A. PhD, MSCI; Gellert, Lan L. MD, PhD; Hameed, Omar MD

Advances In Anatomic Pathology: January 2017 - Volume 24 - Issue 1 - p 35–44
doi: 10.1097/PAP.0000000000000136
Review Articles

The diagnosis of minimal prostatic adenocarcinoma can be challenging on prostate needle biopsy, and immunohistochemistry may be used to support the diagnosis of cancer. The International Society of Urologic Pathology currently recommends the use of the basal cell markers high–molecular-weight cytokeraratin and p63, and α-methylacyl-coenzyme-A racemase. However, there are caveats associated with the interpretation of these markers, particularly with benign mimickers. Another issue is that of early detection of presence and progression of disease and prediction of recurrence after clinical intervention. There remains a lack of reliable biomarkers to accurately predict low-risk cancer and avoid over treatment. As such, aggressive forms of prostate cancer may be missed and indolent disease may be subjected to unnecessary radical therapy. New biomarker discovery promises to improve early detection and prognosis and to provide targets for therapeutic interventions. In this review, we present the emerging immunohistochemical biomarkers of prostate cancer PTEN, ERG, FASN, MAGI-2, and SPINK1, and address their diagnostic and prognostic advantages and limitations.

*Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center

Department of Veterans Affairs, Nashville, TN

S.A.A. was supported by the Department of Veterans Affairs (VA CDA IK2BX002498). The remaining authors have no funding or conflicts of interest to disclose.

Reprints: Giovanna A. Giannico, MD, Departments of Pathology, Microbiology, and Immunology, 1161 21st Avenue South, C-2104C Medical Center North, Nashville, TN 37232-2561 (e-mail:

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