Histopathologic False-positive Diagnoses of Prostate Cancer in the Age of Immunohistochemistry
| Autor: | Henrik Møller, Geraldine Soosay, Holly Sandu, Amar Ahmad, Sakunthala C. Kudahetti, Luis Beltran, Daniel M. Berney, Jack Cuzick |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Cytodiagnosis 030232 urology & nephrology Article Pathology and Forensic Medicine 03 medical and health sciences Prostate cancer 0302 clinical medicine Prostate Humans Medicine False Positive Reactions Diagnostic Errors Intraepithelial neoplasia Suspicious for Malignancy Genitourinary system business.industry Prostatic Neoplasms Cancer Middle Aged Hyperplasia medicine.disease Immunohistochemistry medicine.anatomical_structure 030220 oncology & carcinogenesis Surgery Radiology Anatomy business |
| Zdroj: | American Journal of Surgical Pathology. 43:361-368 |
| ISSN: | 0147-5185 |
| DOI: | 10.1097/pas.0000000000001202 |
| Popis: | There are few studies into the rate and causes of histopathological false-positive diagnosis of prostate cancer. Only two of these, including a previous one from our group, incorporate survival data. In addition, in none of the previous studies had immunohistochemistry been originally requested on any of the misdiagnosed cases. Diagnostic biopsies (n=1080) and trans-urethral resection of prostate specimens (n=314) from 1394 men with clinically localised prostate cancer diagnosed in the UK but treated conservatively between 1990 and 2003 were reviewed by a panel of 3 genitourinary pathologists. Thirty five cases were excluded for being potentially incomplete. Of the remaining 1359, 30 (2.2%) were re-assigned to a non-malignant category (26 benign and 4 suspicious for malignancy). Immunohistochemistry had been originally performed on 7 of these. The reasons for the errors were recorded on each case: adenosis (19), partial atrophy (3), PIN (2), seminal vesicle epithelium (1) and hyperplasia (1). Follow-up of these men revealed only one prostate cancer related death, possibly due to un-sampled tumour. In conclusion, a relatively small number of prostate cancer mimics were responsible for a large proportion of the false-positive prostate cancer diagnoses and the use of immunohistochemistry did not prevent the overcall of benign entities as cancer in approximately a quarter of these cases. Targeting these mimics at educational events and raising awareness of the pitfalls in the interpretation of immunohistochemistry in prostate cancer diagnosis, emphasising that glands within a suspicious focus should be treated as a whole rather than individually, may be beneficial in lowering the rate of false-positive diagnosis. |
| Databáze: | OpenAIRE |
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