Histopathological Analysis of Prostatic Lesions and Role of P63 Versus High Molecular Weight Cytokeratin in Distinguishing Prostatic Carcinoma from Benign Prostatic Lesions and its Precursors.

Prostatic Disease Is Responsible For Significant Morbidity And Mortality In Elderly Men Throughout The World. Prostate Cancer And Benign Prostatic Hyperplasia Are The Two Major Prostate Diseases That Increases With Aging. The Incidence Of Both The Diseases Are Currently Showing A Tendency To Increase. In Particular, Increase In The Incidence Rate And The Number Of Death From Prostate Cancer Are Noteworthy It Is Predicted That The Number Of Affected Individual Will Exceed Those Of Gastric Cancer, Placing It Second To Lung Cancer By The Year 2020.(53) It Is Not Uncommon To Underdiagnose Small Focus Of Prostatic Adenocarcinoma Or Overdiagnose Benign Lesions Mimicking Cancer. It Represents A Potential Liability For Pathologist And May Cause Unfortunate Consequences For Patients. The Diagnosis Of Prostatic Carcinoma Can Usually Be Made On Morphologic Features Which Include Major And Minor Criteria, Like Infitrative Glandular Growth Pattern, Absence Of Basal Cells And Nuclear Atypia, Nuclear Hyperchromasia, Mitotic Figures (Etc). However , The Diagnosis Of Prostatic Carcinoma On Routine Biopsies (Like Trucut) And TURP Can Be Challenging When Pathologist Are Faced With Certain Problems Such As Limited Tissue Samples, Small Foci Of Carcinoma Or Benign Mimickers Of Prostatic Cancer Like Atrophy, Atypical Adenomatous Hyperplasia, Basal Cell Hyperplasia (Etc).(64) Therefore , The Application Of Immunohistochemistry To Distinguish Prostate Cancer From Its Benign Mimickers And To Confirm The Diagnosis Become Helpful And Necessary, Especially In Equivocal Cases.(64,67) The Most Commonly Used Basal Cell-Specific Markers In Prostatic Gland Are High Molecular Weight Cytokeratin (HMWCK) And Newly Described Basal Cell Marker (P63). HMWCK Shows Cytoplasmic Positivity Within The Basal Cells Whereas P63 Shows Nuclear Positivity Within The Basal Cells.(67) This Study Mainly Aims At Evaluating The Actual Incidence Of Differerent Prostatic Lesions In This Institution, As Well As At Evaluating And Comparing The Sensitivity And Specificity Of HMWCK And P63 In Distinguishing Prostatic Carcinoma From Benign Prostatic Lesions