Background and Aims:
Accurate diagnosis of clinically significant prostate cancer is essential in identifying patients who should undergo treatment with curative intent. Pathological reporting was used as gold standard in assessing prostate histology and immunohistochemistry. However, this procedure is invasive; hence, non-invasive tests have been proposed to assess the severity of prostatic lesion. Multi-parametric magnetic resonance imaging (MRI) of prostate is a major diagnostic tool in cancer detection. Prostate Imaging Reporting and Data System (PIRADS) Version 2 was recently issued by The American College of Radiology. Each PIRADS score, ranging from 1 to 5, corresponds to a clinically significant cancer. This study aimed at comparing the diagnostic accuracy of immunohistochemistry (using anti- AMACR and P63 antibodies) and Mp-MRI with PIRAD 2.0 scoring system in different prostatic lesions.
Patients & Methods: A retrospective study carried on 70 patients with prostatic lesions with mean age of 62 years. The patients underwent PR examination, PSA tests, TRU/S, and Mp-MRI prostate and scored by PIRADS scoring system. Immunohistochemistry using anti-AMACR and anti-P63 antibodies was done. Imaging data were correlated with histopathological and immunohistochemical data using SPSS software.
Results:
AMACR expression was restricted to malignant lesions (Prostatic carcinoma) and HGPIN and was negative in BPH and LGPIN specimens (P0.05). P63 is highly sensitive and specific marker for non-malignant prostatic lesions. There was significant relationship between higher PIRADS score and findings of cancer on pathology (p7) tumors were found in MP-MRI with high PIRADS score (4 or 5), but without statistical significant difference (P>0.05) as 81.8% of low grade (Gleason score 6-7, grade |
