The utility of Ki-67 expression in the differential diagnosis of prostatic intraepithelial neoplasia and ductal adenocarcinoma

Rioux-Leclercq, Nathalie; Leray, Emmanuelle; Patard, Jean-Jacques; Lobel, Bernard; Guillé, François; Jouan, Florence; Bellaud, Pascale; Epstein, Jonathan I.

doi:10.1016/j.humpath.2005.01.021

« Previous Next »Human Pathology
Volume 36, Issue 5 , Pages 531-535, May 2005

The utility of Ki-67 expression in the differential diagnosis of prostatic intraepithelial neoplasia and ductal adenocarcinoma

Nathalie Rioux-Leclercq, MD, PhD
- Département d'Anatomie et de Cytologie Pathologiques, Faculté de Médecine, 35043 Rennes Cedex 9, France
- Corresponding author. Département d'Anatomie et de Cytologie Pathologiques, Faculté de Médecine, 2 Avenue du Professeur Léon Bernard, 35043 Rennes Cedex 9, France.
Emmanuelle Leray, MSc
- Département de Santé Publique, Centre Hospitalo–Universitaire Pontchaillou, 35033 Rennes Cedex 9, France
Jean-Jacques Patard, MD, PhD
- Service d'Urologie, Centre Hospitalo–Universitaire Pontchaillou, 35033 Rennes Cedex 9, France
Bernard Lobel, MD
- Service d'Urologie, Centre Hospitalo–Universitaire Pontchaillou, 35033 Rennes Cedex 9, France
François Guillé, MD
- Service d'Urologie, Centre Hospitalo–Universitaire Pontchaillou, 35033 Rennes Cedex 9, France
Florence Jouan, RT
- Département d'Anatomie et de Cytologie Pathologiques, Faculté de Médecine, 35043 Rennes Cedex 9, France
Pascale Bellaud, RT
- Département d'Anatomie et de Cytologie Pathologiques, Faculté de Médecine, 35043 Rennes Cedex 9, France
Jonathan I. Epstein, MD
- Departments of Pathology, Urology and Oncology, The Johns Hopkins Medical Institutions, Baltimore, MD 21231, USA

Received 12 January 2005; accepted 19 January 2005.

Summary

Cribriform and/or papillary prostatic lesions observed on limited tissue, such as needle biopsy, can pose diagnostic dilemmas. One such area of difficulty is the distinction between papillary and/or cribriform prostatic high-grade prostatic intraepithelial neoplasia (HG-PIN) and ductal adenocarcinoma.

Over 48 months, we identified 17 cases of ductal adenocarcinoma and 17 cases of HG-PIN from radical retropubic prostatectomy specimens. The HG-PIN lesions were in all cases associated with an acinar prostatic adenocarcinoma component. For each case, we evaluated the proliferative activity, assessed by Ki-67 immunohistochemistry. The majority (82%) of ductal adenocarcinomas were composed of mixed papillary and cribriform patterns, with the remaining demonstrating pure papillary or cribriform patterns. The HG-PIN lesions showed a papillary, cribriform, or mixed papillary/cribriform architecture. The proliferative activity, defined as Ki-67 labeling index, was statistically higher in ductal adenocarcinoma (mean 33%, range 21%-66%) as compared with HG-PIN (mean 6%, range 2%-15%), with no overlap in the Ki-67 indices (P = 0001).

A combination of histological features and measurements of cellular proliferation may be helpful to distinguish HG-PIN from ductal adenocarcinoma in limited prostatic tissue samples.

Keywords: Ki-67, Prostatic intraepithelial neoplasia, Ductal adenocarcinoma