Association between prostein immune-histochemical expression and histo-pathological grading of prostate cancer urology clinics in Kisumu city experience

Abstract

Background: The degree of morphological differentiation on histological assessment is a limited prediction of PCa aggressiveness. Prostein is being evaluated as additional biomarker in diagnosis and prognostication of prostate cancer.

Objective: To evaluate association of prostein immunoexpression and histopathological grading of prostate needle biopsies from patients with prostate cancer.

Design: A retrospective cross-sectional study

Setting: Urology clinics at Jaramogi Oginga Odinga Teaching and Referral Hospital and Synergy Clinics, Kisumu City from January 2018 to May 2021.

Materials and methods: Tissue blocks from 102 patients retrospectively retrieved, sectioned at 3um in pairs and stained using anti-prostein monoclonal antibodies and routine Hematoxylin and Eosin respectively. The stained sections were examined and confirmed according to WHO/ISUP classification (2014). Prostein intensity and immune-localization was graded as immunoreactive composite score. Chi square and Spearman's correlation tests were used to analyze data.

Results: The mean age was 72.21±0.61 years. Tumour grading were; lower grade (Gleason grade, 1), 23.5% intermediate PCa (Gleason grade group, 2-3) whereas 66.7% constituted high grade PCa (Gleason grade group, 4&5). Focal granular cytoplasmic pattern was 95.1% (97) while 2.0% (2) expressed nucleocytoplasmic pattern and 2.9% (3) were non-stained. The mean ±SD immunohistochemical score was 8.696±4.051. Prostein had weak cytoplasmic expression in higher Gleason grades (4/5) tumors as compared to lower Gleason grade (Gleason grade≤3), r= -0.174; p=0.040.

Conclusion: Prostein immunoexpression is inversely proportional to Gleason grade groups. Further studies on prognostic performance of prostein in poorly differentiated prostate cancer is recommended.