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Immunhistochemische Algorithmen in der Prostatadiagnostik

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Immunohistochemical algorithms in prostate diagnostics

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Zusammenfassung

Die Immunhistochemie hat sich zu einem unverzichtbaren Hilfsmittel in der Prostatabiopsiediagnostik entwickelt. Da der Basalzellverlust als ein definierendes Kennzeichen von Malignität angesehen wird, können vor allem Basalzellmarker in der Differenzialdiagnose benigner und maligner Läsionen hilfreich sein. Basalzellzytokeratine und p63 haben daher schon lange einen festen Platz im diagnostischen Repertoire von Uropathologen. Wünschenswert wäre jedoch, diese Negativmarker durch zusätzliche komplementäre Positivmarker zu ergänzen, um die diagnostische Genauigkeit weiter zu erhöhen. Der am weitesten verbreitete Positivmarker ist die α-Methylazyl-CoA-Razemase (AMACR), die im Prostatakarzinom stark aufreguliert ist und sogar mit p63 in einer einzigen Immunfärbung kombiniert werden kann. Dieser Beitrag gibt einen kurzen und kritischen Überblick über gegenwärtige diagnostische Biomarker des Prostatakarzinoms und schlägt darüber hinaus Golgi-Phosphoprotein 2“ (GOLPH2) und „fatty acid synthase“ (FASN) als zusätzliche diagnostische Marker vor.

Abstract

Immunohistochemistry has become an indispensible tool in biopsy diagnostics of prostate tissues. In particular the use of basal cell markers can be useful to differentiate benign and malignant lesions as a lack of basal cells is considered a hallmark of malignancy. Basal cell cytokeratins and p63 have therefore a long standing place in the diagnostic portfolio of most genito-urinary pathologists. However, to complement the use of these negative markers by additional positive immunohistochemistry markers of malignancy would be desirable to further increase diagnostic accuracy. The most widely used positive marker is alpha-methylacyl-CoA racemase (AMACR), which is strongly upregulated in prostate cancer and which can even be combined with p63 in a single immunostaining. This article briefly and critically reviews current diagnostic prostate cancer biomarkers and also suggests golgi phosphoprotein 2 (GOLPH2) and fatty acid synthase (FASN) as additional diagnostic markers.

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  1. Department Pathologie, Institut für klinische Pathologie, Universitätsspital Zürich (USZ), Schmelzbergstr. 12, 8091, Zürich, Schweiz

    G. Kristiansen

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Kristiansen, G. Immunhistochemische Algorithmen in der Prostatadiagnostik. Pathologe 30 (Suppl 2), 146–153 (2009). https://doi.org/10.1007/s00292-009-1230-4

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  • DOI: https://doi.org/10.1007/s00292-009-1230-4

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