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Tribian LS, Lennartz M, Höflmayer D, de Wispelaere N, Dwertmann Rico S, von Bargen C, Kind S, Reiswich V, Viehweger F, Lutz F, Bertram V, Fraune C, Gorbokon N, Weidemann S, Hube-Magg C, Menz A, Uhlig R, Krech T, Hinsch A, Burandt E, Sauter G, Simon R, Kluth M, Steurer S, Marx AH, Lebok P, Dum D, Minner S, Jacobsen F, Clauditz TS, Bernreuther C. Diagnostic Role and Prognostic Impact of PSAP Immunohistochemistry: A Tissue Microarray Study on 31,358 Cancer Tissues. Diagnostics (Basel) 2023; 13:3242. [PMID: 37892063 PMCID: PMC10606209 DOI: 10.3390/diagnostics13203242] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 10/10/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023] Open
Abstract
Prostate-specific acid phosphatase (PSAP) is a marker for prostate cancer. To assess the specificity and prognostic impact of PSAP, 14,137 samples from 127 different tumor (sub)types, 17,747 prostate cancers, and 76 different normal tissue types were analyzed via immunohistochemistry in a tissue microarray format. In normal tissues, PSAP staining was limited to the prostate epithelial cells. In prostate cancers, PSAP was seen in 100% of Gleason 3 + 3, 95.5% of Gleason 4 + 4, 93.8% of recurrent cancer under androgen deprivation therapy, 91.0% of Gleason 5 + 5, and 31.2% of small cell neuroendocrine cancer. In non-prostatic tumors, PSAP immunostaining was only found in 3.2% of pancreatic neuroendocrine tumors and in 0.8% of diffuse-type gastric adenocarcinomas. In prostate cancer, reduced PSAP staining was strongly linked to an advanced pT stage, a high classical and quantitative Gleason score, lymph node metastasis, high pre-operative PSA levels, early PSA recurrence (p < 0.0001 each), high androgen receptor expression, and TMPRSS2:ERG fusions. A low level of PSAP expression was linked to PSA recurrence independent of pre- and postoperative prognostic markers in ERG-negative cancers. Positive PSAP immunostaining is highly specific for prostate cancer. Reduced PSAP expression is associated with aggressive prostate cancers. These findings make PSAP a candidate marker for prognostic multiparameter panels in ERG-negative prostate cancers.
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Affiliation(s)
- Laura Sophie Tribian
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (L.S.T.); (M.L.); (D.H.); (S.D.R.); (C.v.B.); (S.K.); (V.R.); (F.V.); (F.L.); (V.B.); (C.F.); (N.G.); (S.W.); (C.H.-M.); (A.M.); (R.U.); (T.K.); (A.H.); (E.B.); (G.S.); (M.K.); (S.S.); (P.L.); (D.D.); (S.M.); (F.J.); (T.S.C.); (C.B.)
| | - Maximilian Lennartz
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (L.S.T.); (M.L.); (D.H.); (S.D.R.); (C.v.B.); (S.K.); (V.R.); (F.V.); (F.L.); (V.B.); (C.F.); (N.G.); (S.W.); (C.H.-M.); (A.M.); (R.U.); (T.K.); (A.H.); (E.B.); (G.S.); (M.K.); (S.S.); (P.L.); (D.D.); (S.M.); (F.J.); (T.S.C.); (C.B.)
| | - Doris Höflmayer
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (L.S.T.); (M.L.); (D.H.); (S.D.R.); (C.v.B.); (S.K.); (V.R.); (F.V.); (F.L.); (V.B.); (C.F.); (N.G.); (S.W.); (C.H.-M.); (A.M.); (R.U.); (T.K.); (A.H.); (E.B.); (G.S.); (M.K.); (S.S.); (P.L.); (D.D.); (S.M.); (F.J.); (T.S.C.); (C.B.)
| | - Noémi de Wispelaere
- Department of General, Visceral, and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany;
| | - Sebastian Dwertmann Rico
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (L.S.T.); (M.L.); (D.H.); (S.D.R.); (C.v.B.); (S.K.); (V.R.); (F.V.); (F.L.); (V.B.); (C.F.); (N.G.); (S.W.); (C.H.-M.); (A.M.); (R.U.); (T.K.); (A.H.); (E.B.); (G.S.); (M.K.); (S.S.); (P.L.); (D.D.); (S.M.); (F.J.); (T.S.C.); (C.B.)
| | - Clara von Bargen
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (L.S.T.); (M.L.); (D.H.); (S.D.R.); (C.v.B.); (S.K.); (V.R.); (F.V.); (F.L.); (V.B.); (C.F.); (N.G.); (S.W.); (C.H.-M.); (A.M.); (R.U.); (T.K.); (A.H.); (E.B.); (G.S.); (M.K.); (S.S.); (P.L.); (D.D.); (S.M.); (F.J.); (T.S.C.); (C.B.)
| | - Simon Kind
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (L.S.T.); (M.L.); (D.H.); (S.D.R.); (C.v.B.); (S.K.); (V.R.); (F.V.); (F.L.); (V.B.); (C.F.); (N.G.); (S.W.); (C.H.-M.); (A.M.); (R.U.); (T.K.); (A.H.); (E.B.); (G.S.); (M.K.); (S.S.); (P.L.); (D.D.); (S.M.); (F.J.); (T.S.C.); (C.B.)
| | - Viktor Reiswich
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (L.S.T.); (M.L.); (D.H.); (S.D.R.); (C.v.B.); (S.K.); (V.R.); (F.V.); (F.L.); (V.B.); (C.F.); (N.G.); (S.W.); (C.H.-M.); (A.M.); (R.U.); (T.K.); (A.H.); (E.B.); (G.S.); (M.K.); (S.S.); (P.L.); (D.D.); (S.M.); (F.J.); (T.S.C.); (C.B.)
| | - Florian Viehweger
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (L.S.T.); (M.L.); (D.H.); (S.D.R.); (C.v.B.); (S.K.); (V.R.); (F.V.); (F.L.); (V.B.); (C.F.); (N.G.); (S.W.); (C.H.-M.); (A.M.); (R.U.); (T.K.); (A.H.); (E.B.); (G.S.); (M.K.); (S.S.); (P.L.); (D.D.); (S.M.); (F.J.); (T.S.C.); (C.B.)
| | - Florian Lutz
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (L.S.T.); (M.L.); (D.H.); (S.D.R.); (C.v.B.); (S.K.); (V.R.); (F.V.); (F.L.); (V.B.); (C.F.); (N.G.); (S.W.); (C.H.-M.); (A.M.); (R.U.); (T.K.); (A.H.); (E.B.); (G.S.); (M.K.); (S.S.); (P.L.); (D.D.); (S.M.); (F.J.); (T.S.C.); (C.B.)
| | - Veit Bertram
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (L.S.T.); (M.L.); (D.H.); (S.D.R.); (C.v.B.); (S.K.); (V.R.); (F.V.); (F.L.); (V.B.); (C.F.); (N.G.); (S.W.); (C.H.-M.); (A.M.); (R.U.); (T.K.); (A.H.); (E.B.); (G.S.); (M.K.); (S.S.); (P.L.); (D.D.); (S.M.); (F.J.); (T.S.C.); (C.B.)
| | - Christoph Fraune
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (L.S.T.); (M.L.); (D.H.); (S.D.R.); (C.v.B.); (S.K.); (V.R.); (F.V.); (F.L.); (V.B.); (C.F.); (N.G.); (S.W.); (C.H.-M.); (A.M.); (R.U.); (T.K.); (A.H.); (E.B.); (G.S.); (M.K.); (S.S.); (P.L.); (D.D.); (S.M.); (F.J.); (T.S.C.); (C.B.)
| | - Natalia Gorbokon
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (L.S.T.); (M.L.); (D.H.); (S.D.R.); (C.v.B.); (S.K.); (V.R.); (F.V.); (F.L.); (V.B.); (C.F.); (N.G.); (S.W.); (C.H.-M.); (A.M.); (R.U.); (T.K.); (A.H.); (E.B.); (G.S.); (M.K.); (S.S.); (P.L.); (D.D.); (S.M.); (F.J.); (T.S.C.); (C.B.)
| | - Sören Weidemann
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (L.S.T.); (M.L.); (D.H.); (S.D.R.); (C.v.B.); (S.K.); (V.R.); (F.V.); (F.L.); (V.B.); (C.F.); (N.G.); (S.W.); (C.H.-M.); (A.M.); (R.U.); (T.K.); (A.H.); (E.B.); (G.S.); (M.K.); (S.S.); (P.L.); (D.D.); (S.M.); (F.J.); (T.S.C.); (C.B.)
| | - Claudia Hube-Magg
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (L.S.T.); (M.L.); (D.H.); (S.D.R.); (C.v.B.); (S.K.); (V.R.); (F.V.); (F.L.); (V.B.); (C.F.); (N.G.); (S.W.); (C.H.-M.); (A.M.); (R.U.); (T.K.); (A.H.); (E.B.); (G.S.); (M.K.); (S.S.); (P.L.); (D.D.); (S.M.); (F.J.); (T.S.C.); (C.B.)
| | - Anne Menz
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (L.S.T.); (M.L.); (D.H.); (S.D.R.); (C.v.B.); (S.K.); (V.R.); (F.V.); (F.L.); (V.B.); (C.F.); (N.G.); (S.W.); (C.H.-M.); (A.M.); (R.U.); (T.K.); (A.H.); (E.B.); (G.S.); (M.K.); (S.S.); (P.L.); (D.D.); (S.M.); (F.J.); (T.S.C.); (C.B.)
| | - Ria Uhlig
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (L.S.T.); (M.L.); (D.H.); (S.D.R.); (C.v.B.); (S.K.); (V.R.); (F.V.); (F.L.); (V.B.); (C.F.); (N.G.); (S.W.); (C.H.-M.); (A.M.); (R.U.); (T.K.); (A.H.); (E.B.); (G.S.); (M.K.); (S.S.); (P.L.); (D.D.); (S.M.); (F.J.); (T.S.C.); (C.B.)
| | - Till Krech
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (L.S.T.); (M.L.); (D.H.); (S.D.R.); (C.v.B.); (S.K.); (V.R.); (F.V.); (F.L.); (V.B.); (C.F.); (N.G.); (S.W.); (C.H.-M.); (A.M.); (R.U.); (T.K.); (A.H.); (E.B.); (G.S.); (M.K.); (S.S.); (P.L.); (D.D.); (S.M.); (F.J.); (T.S.C.); (C.B.)
- Institute of Pathology, Clinical Center Osnabrueck, 49076 Osnabrueck, Germany
| | - Andrea Hinsch
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (L.S.T.); (M.L.); (D.H.); (S.D.R.); (C.v.B.); (S.K.); (V.R.); (F.V.); (F.L.); (V.B.); (C.F.); (N.G.); (S.W.); (C.H.-M.); (A.M.); (R.U.); (T.K.); (A.H.); (E.B.); (G.S.); (M.K.); (S.S.); (P.L.); (D.D.); (S.M.); (F.J.); (T.S.C.); (C.B.)
| | - Eike Burandt
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (L.S.T.); (M.L.); (D.H.); (S.D.R.); (C.v.B.); (S.K.); (V.R.); (F.V.); (F.L.); (V.B.); (C.F.); (N.G.); (S.W.); (C.H.-M.); (A.M.); (R.U.); (T.K.); (A.H.); (E.B.); (G.S.); (M.K.); (S.S.); (P.L.); (D.D.); (S.M.); (F.J.); (T.S.C.); (C.B.)
| | - Guido Sauter
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (L.S.T.); (M.L.); (D.H.); (S.D.R.); (C.v.B.); (S.K.); (V.R.); (F.V.); (F.L.); (V.B.); (C.F.); (N.G.); (S.W.); (C.H.-M.); (A.M.); (R.U.); (T.K.); (A.H.); (E.B.); (G.S.); (M.K.); (S.S.); (P.L.); (D.D.); (S.M.); (F.J.); (T.S.C.); (C.B.)
| | - Ronald Simon
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (L.S.T.); (M.L.); (D.H.); (S.D.R.); (C.v.B.); (S.K.); (V.R.); (F.V.); (F.L.); (V.B.); (C.F.); (N.G.); (S.W.); (C.H.-M.); (A.M.); (R.U.); (T.K.); (A.H.); (E.B.); (G.S.); (M.K.); (S.S.); (P.L.); (D.D.); (S.M.); (F.J.); (T.S.C.); (C.B.)
| | - Martina Kluth
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (L.S.T.); (M.L.); (D.H.); (S.D.R.); (C.v.B.); (S.K.); (V.R.); (F.V.); (F.L.); (V.B.); (C.F.); (N.G.); (S.W.); (C.H.-M.); (A.M.); (R.U.); (T.K.); (A.H.); (E.B.); (G.S.); (M.K.); (S.S.); (P.L.); (D.D.); (S.M.); (F.J.); (T.S.C.); (C.B.)
| | - Stefan Steurer
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (L.S.T.); (M.L.); (D.H.); (S.D.R.); (C.v.B.); (S.K.); (V.R.); (F.V.); (F.L.); (V.B.); (C.F.); (N.G.); (S.W.); (C.H.-M.); (A.M.); (R.U.); (T.K.); (A.H.); (E.B.); (G.S.); (M.K.); (S.S.); (P.L.); (D.D.); (S.M.); (F.J.); (T.S.C.); (C.B.)
| | - Andreas H. Marx
- Department of Pathology, Academic Hospital Fuerth, 90766 Fuerth, Germany;
| | - Patrick Lebok
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (L.S.T.); (M.L.); (D.H.); (S.D.R.); (C.v.B.); (S.K.); (V.R.); (F.V.); (F.L.); (V.B.); (C.F.); (N.G.); (S.W.); (C.H.-M.); (A.M.); (R.U.); (T.K.); (A.H.); (E.B.); (G.S.); (M.K.); (S.S.); (P.L.); (D.D.); (S.M.); (F.J.); (T.S.C.); (C.B.)
- Institute of Pathology, Clinical Center Osnabrueck, 49076 Osnabrueck, Germany
| | - David Dum
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (L.S.T.); (M.L.); (D.H.); (S.D.R.); (C.v.B.); (S.K.); (V.R.); (F.V.); (F.L.); (V.B.); (C.F.); (N.G.); (S.W.); (C.H.-M.); (A.M.); (R.U.); (T.K.); (A.H.); (E.B.); (G.S.); (M.K.); (S.S.); (P.L.); (D.D.); (S.M.); (F.J.); (T.S.C.); (C.B.)
| | - Sarah Minner
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (L.S.T.); (M.L.); (D.H.); (S.D.R.); (C.v.B.); (S.K.); (V.R.); (F.V.); (F.L.); (V.B.); (C.F.); (N.G.); (S.W.); (C.H.-M.); (A.M.); (R.U.); (T.K.); (A.H.); (E.B.); (G.S.); (M.K.); (S.S.); (P.L.); (D.D.); (S.M.); (F.J.); (T.S.C.); (C.B.)
| | - Frank Jacobsen
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (L.S.T.); (M.L.); (D.H.); (S.D.R.); (C.v.B.); (S.K.); (V.R.); (F.V.); (F.L.); (V.B.); (C.F.); (N.G.); (S.W.); (C.H.-M.); (A.M.); (R.U.); (T.K.); (A.H.); (E.B.); (G.S.); (M.K.); (S.S.); (P.L.); (D.D.); (S.M.); (F.J.); (T.S.C.); (C.B.)
| | - Till S. Clauditz
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (L.S.T.); (M.L.); (D.H.); (S.D.R.); (C.v.B.); (S.K.); (V.R.); (F.V.); (F.L.); (V.B.); (C.F.); (N.G.); (S.W.); (C.H.-M.); (A.M.); (R.U.); (T.K.); (A.H.); (E.B.); (G.S.); (M.K.); (S.S.); (P.L.); (D.D.); (S.M.); (F.J.); (T.S.C.); (C.B.)
| | - Christian Bernreuther
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (L.S.T.); (M.L.); (D.H.); (S.D.R.); (C.v.B.); (S.K.); (V.R.); (F.V.); (F.L.); (V.B.); (C.F.); (N.G.); (S.W.); (C.H.-M.); (A.M.); (R.U.); (T.K.); (A.H.); (E.B.); (G.S.); (M.K.); (S.S.); (P.L.); (D.D.); (S.M.); (F.J.); (T.S.C.); (C.B.)
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He M, Zhang D, Cao Y, Chi C, Zeng Z, Yang X, Yang G, Sharma K, Hu K, Enikeev M. Chimeric antigen receptor-modified T cells therapy in prostate cancer: A comprehensive review on the current state and prospects. Heliyon 2023; 9:e19147. [PMID: 37664750 PMCID: PMC10469587 DOI: 10.1016/j.heliyon.2023.e19147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 07/31/2023] [Accepted: 08/14/2023] [Indexed: 09/05/2023] Open
Abstract
Recent immunotherapy research has focused on chimeric antigen receptor-modified T cells (CAR-Ts). CAR-T therapies have been clinically applied to manage hematologic malignancies with satisfactory effectiveness. However, the application of CAR-T immunotherapy in solid tumors remains challenging. Even so, current CAR-T immunotherapies for prostate cancer (PCa) have shown some promise, giving hope to patients with advanced metastatic PCa. This review aimed to elucidate different types of prostate tumor-associated antigen targets, such as prostate-specific membrane antigen and prostate stem cell antigen, and their effects. The current status of the corresponding targets in clinical research through their applications was also discussed. To improve the efficacy of CAR-T immunotherapy, we addressed the possible applications of multimodal immunotherapy, chemotherapy, and CAR-T combined therapies. The obstacles of solid tumors were concisely elaborated. Further studies should aim to discover novel potential targets and establish new models by overcoming the inherent barriers of solid tumors, such as tumor heterogeneity and the immunosuppressive nature of the tumor microenvironment.
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Affiliation(s)
- Mingze He
- Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119435, Moscow, Russia
| | - Dongqi Zhang
- Department of Urology, The First Hospital of Jilin University (Lequn Branch), 130000, Changchun, China
| | - Yu Cao
- I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991, Moscow, Russia
| | - Changliang Chi
- Department of Urology, The First Hospital of Jilin University (Lequn Branch), 130000, Changchun, China
| | - Zitong Zeng
- I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991, Moscow, Russia
| | - Xinyi Yang
- I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991, Moscow, Russia
| | - Guodong Yang
- I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991, Moscow, Russia
| | - Kritika Sharma
- I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991, Moscow, Russia
| | - Kebang Hu
- Department of Urology, The First Hospital of Jilin University (Lequn Branch), 130000, Changchun, China
| | - Mikhail Enikeev
- Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119435, Moscow, Russia
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Matrood S, Apostolidis L, Schrader J, Krug S, Lahner H, Ramaswamy A, Librizzi D, Kender Z, Kröcher A, Kreutzfeldt S, Gress TM, Rinke A. Multicenter Analysis of Presacral Neuroendocrine Neoplasms-Clinicopathological Characterization and Treatment Outcomes of a Rare Disease. Front Endocrinol (Lausanne) 2021; 12:709256. [PMID: 34690926 PMCID: PMC8527170 DOI: 10.3389/fendo.2021.709256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 09/10/2021] [Indexed: 11/17/2022] Open
Abstract
Background and Aims Neuroendocrine neoplasms (NENs) of the presacral space are an extremely rare disease entity with largely unknown outcome and no established standard of care treatment. Therefore, we wanted to analyze clinical presentation, histopathological findings, treatment outcomes, and prognosis in a multicentric patient cohort. Methods We searched local databases of six German NEN centers for patients with presacral NEN. Retrospective descriptive analyses of age, sex, stage at diagnosis, symptoms, grade, immunohistochemical investigations, biomarkers, treatment, and treatment outcome were performed. Kaplan-Meier analysis was used to determine median overall survival. Results We identified 17 patients (11 female, 6 male) with a median age of 50 years (range, 35-66) at diagnosis. Twelve cases presented initially with distant metastases including bone metastases in nine cases. On pathological review the majority of patients had well-differentiated G2 tumors. Immunohistochemical profile resembled rectal NENs. All but one patient had non-functioning tumors. Somatostatin receptor imaging was positive in 14 of 15 investigated cases. Eight patients were treated surgically including palliative resections; 14 patients received somatostatin analogs with limited efficacy. With 14 PRRTs completed, 79% showed clinical benefit, whereas only one patient with neuroendocrine carcinoma (NEC) responded to chemotherapy. Treatment with everolimus in three patients was not successful, whereas cabozantinib resulted in a disease stabilization in a heavily pretreated patient. During a median observation period of 44.5 months, 6 patients died. Median overall survival was not reached. Conclusion Presacral NEN are histopathologically similar to rectal NENs. Presacral NEN should be considered as possible primary in NEN of unknown primary. The majority of tumors is non-functioning and somatostatin receptor positive. PRRT demonstrated promising activity; tyrosine kinase inhibitors warrant further investigations. Further molecular characterization and prospective evaluation of this rare tumor entity are needed.
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Affiliation(s)
- Sami Matrood
- Department of Gastroenterology and Endocrinology, UKGM Marburg and Philipps University, Marburg, Germany
| | - Leonidas Apostolidis
- Department of Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg University Hospital, Heidelberg, Germany
| | - Jörg Schrader
- I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sebastian Krug
- Clinic for Internal Medicine I, Martin-Luther University Halle/Wittenberg, Halle, Germany
| | - Harald Lahner
- Department of Endocrinology and Metabolism, University Hospital Essen, Essen, Germany
| | - Annette Ramaswamy
- Institute of Pathology, UKGM Marburg and Philipps University, Marburg, Germany
| | - Damiano Librizzi
- Department of Nuclear Medicine, UKGM Marburg and Philipps University, Marburg, Germany
| | - Zoltan Kender
- Department of Internal Medicine I and Clinical Chemistry, Heidelberg University Hospital, Heidelberg, Germany
| | - Anke Kröcher
- Clinic for Internal Medicine I, University Hospital Carl Gustav Carus Dresden, Dresden, Germany
| | - Simon Kreutzfeldt
- Department of Translational Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Thomas Matthias Gress
- Department of Gastroenterology and Endocrinology, UKGM Marburg and Philipps University, Marburg, Germany
| | - Anja Rinke
- Department of Gastroenterology and Endocrinology, UKGM Marburg and Philipps University, Marburg, Germany
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Bellizzi AM, Montgomery EA, Hornick JL. American Registry of Pathology Expert Opinions: Evaluation of poorly differentiated malignant neoplasms on limited samples - Gastrointestinal mucosal biopsies. Ann Diagn Pathol 2019; 44:151419. [PMID: 31786484 DOI: 10.1016/j.anndiagpath.2019.151419] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
This review reflects a collaboration between the American Registry of Pathology (the publisher of the Armed Forces Institute of Pathology Fascicles) and Annals of Diagnostic Pathology. It is part of a series of expert recommendations on topics encountered in daily practice. The authors, three pathologists with expertise in gastrointestinal tract pathology and immunohistochemistry, met on 30 July 2019 tasked with developing expert recommendations for evaluating poorly differentiated and undifferentiated malignant neoplasms encountered on mucosal biopsies of the gastrointestinal tract. We focused on esophageal, gastric, small intestinal, colorectal, and anal (i.e., tubal gut) samples. When faced with diagnostic uncertainty on the initial H&E, it is best to begin by trying to assign the broad tumor class with screening markers such as pankeratin, S100 protein or SOX10, and CD20 or CD45. Once a broad tumor class is established, more specific differentiation markers can be pursued (e.g., lineage-restricted transcription factors for adenocarcinoma; p40 for squamous cell carcinoma; chromogranin A and synaptophysin or INSM1 for neuroendocrine neoplasms). Every small biopsy containing tumor should be considered a potential molecular pathology sample; cutting extra unstained slides with this testing in mind is strongly encouraged.
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Affiliation(s)
- Andrew M Bellizzi
- University of Iowa Hospitals and Clinics, Department of Pathology, 200 Hawkins Drive, Iowa City, IA 52242, United States of America.
| | | | - Jason L Hornick
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States of America
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5
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Bellur S, Van der Kwast T, Mete O. Evolving concepts in prostatic neuroendocrine manifestations: from focal divergent differentiation to amphicrine carcinoma. Hum Pathol 2018; 85:313-327. [PMID: 30481509 DOI: 10.1016/j.humpath.2018.11.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 11/11/2018] [Accepted: 11/15/2018] [Indexed: 12/31/2022]
Abstract
Prostatic neuroendocrine manifestations encompass a heterogeneous spectrum of morphologic entities. In the era of evidence-based and precision-led treatment, distinction of biologically relevant clinical manifestations expanded the evolving clinical role of pathologists. Recent observations on the occurrence of hormone therapy-induced aggressive prostatic cancers with neuroendocrine features have triggered the need to refine the spectrum and nomenclature of prostatic neuroendocrine manifestations. Although the morphologic assessment still remains the basis of the diagnostic workup of prostatic neoplasms, the application of ancillary biomarkers is crucial in the accurate classification of such presentations. This review provides a diagnostic roadmap for the practicing pathologist by reviewing the characteristic morphologic, immunohistochemical, and molecular correlates of various faces of prostatic neuroendocrine manifestations.
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Affiliation(s)
- Shubha Bellur
- Department of Pathology, University Health Network, Toronto, ON M5G 2C4, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Theodorus Van der Kwast
- Department of Pathology, University Health Network, Toronto, ON M5G 2C4, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Ozgur Mete
- Department of Pathology, University Health Network, Toronto, ON M5G 2C4, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A1, Canada; Endocrine Oncology, The Princess Margaret Cancer Centre, Toronto, ON M5G 2M9, Canada.
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6
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Abstract
Neuroendocrine tumours are uncommon or rare at all sites in the female genital tract. The 2014 World Health Organisation (WHO) Classification of neuroendocrine tumours of the endometrium, cervix, vagina and vulva has been updated with adoption of the terms low-grade neuroendocrine tumour and high-grade neuroendocrine carcinoma. In the endometrium and cervix, high-grade neoplasms are much more prevalent than low-grade and are more common in the cervix than the corpus. In the ovary, low-grade tumours are more common than high-grade carcinomas and the term carcinoid tumour is still used in WHO 2014. The term ovarian small-cell carcinoma of pulmonary type is included in WHO 2014 for a tumour which in other organs is termed high small-cell neuroendocrine carcinoma. Neuroendocrine tumours at various sites within the female genital tract often occur in association with other neoplasms and more uncommonly in pure form.
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7
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Pathological Analysis of Abdominal Neuroendocrine Tumors. Updates Surg 2018. [DOI: 10.1007/978-88-470-3955-1_9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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8
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[Retrorectal space-occupying lesion: a rare differential diagnosis]. Chirurg 2016; 87:785-789. [PMID: 26960335 DOI: 10.1007/s00104-016-0161-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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9
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Koo J, Dhall D. Problems with the diagnosis of metastatic neuroendocrine neoplasms. Which diagnostic criteria should we use to determine tumor origin and help guide therapy? Semin Diagn Pathol 2015; 32:456-68. [PMID: 26573790 DOI: 10.1053/j.semdp.2015.09.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Neuroendocrine neoplasms (NENs) can often present with metastatic disease before the primary tumor is discovered. Metastatic lesions are generally classified as well differentiated and poorly differentiated for prognostic and therapeutic purposes. In addition, for well-differentiated neuroendocrine tumors (WDNETs), pathologists are expected to determine the site of origin, if not already known, and grade the tumors. However, it is often difficult for pathologists to provide this information with certainty without knowing the site of tumor origin, as different criteria have been proposed by WHO for classification of gastrointestinal and pulmonary NENs. In this review, we will discuss the current classification and grading schema of NENs and their impact on clinical care, the differential diagnosis of NENs, the use of immunohistochemical stains that help identify tumor site of origin, and a proposed approach for the diagnosis and classification of metastatic NENs.
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Affiliation(s)
- Jamie Koo
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California
| | - Deepti Dhall
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California.
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10
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Koo J, Zhou X, Moschiano E, De Peralta-Venturina M, Mertens RB, Dhall D. The immunohistochemical expression of islet 1 and PAX8 by rectal neuroendocrine tumors should be taken into account in the differential diagnosis of metastatic neuroendocrine tumors of unknown primary origin. Endocr Pathol 2013; 24:184-90. [PMID: 24037217 DOI: 10.1007/s12022-013-9264-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Rectal neuroendocrine tumors (NETs) can be classified by histologic pattern and secretory products. Recently, rectal NETs have been noted to exhibit immunohistochemical (IHC) positivity for Islet 1 and PAX8, which are generally considered markers for NETs of pancreatic origin. In this study, we sought to characterize the IHC staining profile of rectal NETs and determine whether there was any correlation between the histologic pattern of rectal NETs and their IHC profile. Fifty-six primary rectal NETs were histologically reviewed and stained with antibodies against Islet 1, PAX8, CDX2, chromogranin A, and synaptophysin. In a subset of 31 cases, immunoreactivity for serotonin, pancreatic polypeptide (PP), and prostatic acid phosphatase (PAP) was also studied. By morphology, the tumors studied included 55 % trabecular, 27 % solid nested, 4 % acinar, and 14 % mixed patterns. Islet 1 was positive in 89 % and PAX8 in 79 % of cases. CDX2 was negative in all 56 cases. Cytoplasmic staining was observed for chromogranin A in 30 % of cases and for synaptophysin in all 56 cases. Cytoplasmic staining for serotonin, PP, and PAP was present in 16, 61, and 97 % of cases, respectively. There was no correlation between histologic pattern and IHC staining pattern with any of the antibodies studied. We have demonstrated that Islet 1 and PAX8 are not entirely specific for NETs of pancreatic origin, as they are expressed in a majority of rectal NETs. Since rectal NETs may show an IHC staining profile which mirrors that of pancreatic NETs (Islet 1 and PAX8-positive, CDX2-negative), a metastatic rectal NET should be considered in the differential diagnosis and ruled out clinically in the work-up of a metastatic NET of unknown primary origin which exhibits this staining profile.
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Affiliation(s)
- Jamie Koo
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA,
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11
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Menter T, Fischmann A, Glatz K. [PSAP expression in a primary presacral neuroendocrine tumor. Potential for confusion with prostate cancer]. DER PATHOLOGE 2013; 35:277-82. [PMID: 24043213 DOI: 10.1007/s00292-013-1855-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Primary presacral neuroendocrine tumors are a rare entity with less than 30 cases described in the literature so far. Here we report of a primary presacral neuroendocrine tumor diagnosed at autopsy which was wrongly diagnosed as metastasized prostate cancer before. Misdiagnosis was due to the localization of the tumor, its morphology and its positivity for prostate-specific acid phosphatase (PSAP) when the patient was alive. This is the first report of PSAP and somatostatin receptor expression in this type of tumor.
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Affiliation(s)
- T Menter
- Institut für Pathologie, Universitätsspital Basel, Schönbeinstr. 40, 4032, Basel, Schweiz
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12
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Abstract
Gastrointestinal (GI) neuroendocrine tumors (NETs) are a heterogeneous group of relatively slow-growing neoplasms with marked site-specific differences in hormonal secretion and clinical behavior. Most are sporadic neoplasms, with only 5% to 10% arising in patients with hereditary disorders, most commonly in multiple endocrine neoplasia type 1. Although a uniform terminology is not universally accepted, use of the 4-category WHO classification of these tumors is becoming more widespread, and recommendations for tumor grading and staging have been recently formulated. Most GI NETs are easily recognized on routine histologic examination; rarely, a limited panel of immunohistochemical markers may be useful in establishing the diagnosis. This article describes general and site-specific features of these tumors and outlines potential pitfalls in diagnosis.
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Affiliation(s)
- Roger K Moreira
- Department of Pathology, Columbia University Medical Center, 630 West 168th Street, New York, NY 20032, USA
| | - Kay Washington
- Department of Pathology, Vanderbilt University Medical Center, 1161 21st Avenue South, Nashville, TN 32732, USA.
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13
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Washington MK, Tang LH, Berlin J, Branton PA, Burgart LJ, Carter DK, Compton CC, Fitzgibbons PL, Frankel WL, Jessup JM, Kakar S, Minsky B, Nakhleh RE. Protocol for the examination of specimens from patients with neuroendocrine tumors (carcinoid tumors) of the colon and rectum. Arch Pathol Lab Med 2010; 134:176-80. [PMID: 20121603 DOI: 10.5858/134.2.176] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Mary Kay Washington
- Department of Pathology, C-3316 MCN, Vanderbilt University Medical Center, Nashville, TN 37232-2561, USA.
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14
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Washington MK, Tang LH, Berlin J, Branton PA, Burgart LJ, Carter DK, Compton CC, Fitzgibbons PL, Frankel WL, Jessup JM, Kakar S, Minsky B, Nakhleh RE. Protocol for the Examination of Specimens From Patients With Neuroendocrine Tumors (Carcinoid Tumors) of the Small Intestine and Ampulla. Arch Pathol Lab Med 2010; 134:181-6. [DOI: 10.5858/134.2.181] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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15
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Washington MK, Tang LH, Berlin J, Branton PA, Burgart LJ, Carter DK, Compton CC, Fitzgibbons PL, Frankel WL, Jessup JM, Kakar S, Minsky B, Nakhleh RE. Protocol for the Examination of Specimens From Patients With Neuroendocrine Tumors (Carcinoid Tumors) of the Stomach. Arch Pathol Lab Med 2010; 134:187-91. [DOI: 10.5858/134.2.187] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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16
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Terasaki Y, Shichijo S, Niu Y, Komatsu N, Noguchi M, Todo S, Itoh K. An HLA-A3-binding prostate acid phosphatase-derived peptide can induce CTLs restricted to HLA-A2 and -A24 alleles. Cancer Immunol Immunother 2009; 58:1877-85. [PMID: 19330328 PMCID: PMC11030184 DOI: 10.1007/s00262-009-0699-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2008] [Accepted: 03/12/2009] [Indexed: 10/21/2022]
Abstract
We previously reported peptide vaccine candidates for HLA-A3 supertype (-A3, -A11, -A31, -A33)-positive cancer patients. In the present study, we examined whether those peptides can also induce cytotoxic T lymphocyte (CTL) activity restricted to HLA-A2, HLA-A24, and HLA-A26 alleles. Fourteen peptides were screened for their binding activity to HLA-A*0201, -A*0206, -A*0207, -A*2402, and -A*2601 molecules and then tested for their ability to induce CTL activity in peripheral blood mononuclear cells (PBMCs) from prostate cancer patients. Among these peptides, one from the prostate acid phosphatase protein exhibited binding activity to HLA-A*0201, -A*0206, and -A*2402 molecules. In addition, PBMCs stimulated with this peptide showed that HLA-A2 or HLA-A24 restricted CTL activity. Their cytotoxicity toward cancer cells was ascribed to peptide-specific and CD8+ T cells. These results suggest that this peptide could be widely applicable as a peptide vaccine for HLA-A3 supertype-, HLA-A2-, and -A24-positive cancer patients.
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Affiliation(s)
- Yasunobu Terasaki
- Department of Immunology and Immunotherapy, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011 Japan
- Department of Surgery, Hokkaido University School of Medicine, N15-W7, Kita-ku, Sapporo, 060-8638 Japan
| | - Shigeki Shichijo
- Department of Immunology and Immunotherapy, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011 Japan
| | - Yamei Niu
- Department of Immunology and Immunotherapy, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011 Japan
| | - Nobukazu Komatsu
- Department of Immunology and Immunotherapy, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011 Japan
| | - Masanori Noguchi
- Department of Urology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011 Japan
| | - Satoru Todo
- Department of Surgery, Hokkaido University School of Medicine, N15-W7, Kita-ku, Sapporo, 060-8638 Japan
| | - Kyogo Itoh
- Department of Immunology and Immunotherapy, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011 Japan
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17
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Walter T, Mege-Lechevallier F, Scoazec JY, Martin X, Chayvialle JA, Lombard-Bohas C. Well-differentiated endocrine carcinoma of the renal pelvis: report of a case with sustained objective response to octreotide. Pathol Res Pract 2008; 205:183-7. [PMID: 19041194 DOI: 10.1016/j.prp.2008.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2008] [Revised: 08/31/2008] [Accepted: 10/07/2008] [Indexed: 11/29/2022]
Abstract
Endocrine tumors of the upper urogenital tract are extremely rare. We report the case of a patient with a primary well-differentiated endocrine carcinoma of the renal pelvis metastatic to the liver, in whom an objective response was obtained under octreotide treatment. A 36-year-old woman without symptoms was admitted for exploration of a solid nodule in the right kidney. A right nephrectomy was performed. The histological examination of the surgical specimen diagnosed a primary well-differentiated endocrine tumor of the renal pelvis. Tumor cells strongly expressed synaptophysin and were focally positive for chromogranin A; they displayed faint reactivity for PSAP. Three months later, multiple liver metastases, proved by biopsy, were diagnosed. After two lines of chemotherapy, octreotide treatment was initiated because of persistent high activity at scintigraphic examination. A marked decrease in tumor volume and in chromogranin A serum levels was obtained. Two years later, there was no further progression. The patient was treated with octreotide. Our report points out the unusual immunophenotypic features which may be encountered in well-differentiated endocrine carcinoma of the upper urogenital tract and the potential interest in somatostatin analogues in the treatment of metastatic cases.
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Affiliation(s)
- Thomas Walter
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Fédération des Spécialités Digestives, 69437 Lyon cedex 03, France.
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18
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[A TNM classification for digestive endocrine tumors of midgut and hindgut: proposals from the European Neuroendocrine Tumor Society (ENETS)]. Ann Pathol 2008; 27:426-32. [PMID: 18554552 DOI: 10.1016/s0242-6498(07)71414-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2008] [Indexed: 01/04/2023]
Abstract
The recent proposals for a TNM classification of midgut and hindgut endocrine tumors made by the European Neuroendocrine Tumor Society (ENETS) are presented and commented. Certain particular points, such as the evaluation of the risk of malignancy of an endocrine tumor discovered fortuitously after appendicectomy and the indication of an additional surgical treatment, are developed. Finally, other questions frequently asked about digestive endocrine tumors are addressed.
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19
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Huang J, Yao JL, di Sant'Agnese PA, Yang Q, Bourne PA, Na Y. Immunohistochemical characterization of neuroendocrine cells in prostate cancer. Prostate 2006; 66:1399-406. [PMID: 16865726 DOI: 10.1002/pros.20434] [Citation(s) in RCA: 87] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Neuroendocrine (NE) cells increase in high grade/stage prostate cancer (PC) and may contribute to androgen-independent cancer. Their immunohistochemical phenotype has not been studied in detail and conflicting results have been reported. METHODS PC tissue was stained immunohistochemically for luminal secretory cell-associated cytokeratin, basal cell markers, ki-67, androgen receptor (AR), PSA, prostate acid phosphatase (PAP), and alpha-methylacyl coenzyme A racemase (AMACR). RESULTS The NE cells are positive for AE1/AE3, Cam 5.2, and negative for basal cell markers. They are negative for AR, PSA, and Ki-67 but positive for PAP. The benign NE cells are negative for AMACR while the malignant NE cells are positive for AMACR. CONCLUSIONS NE cells of PC constitute a unique subset of cancer cells, which have a unique immunohistochemical profile. They do not express AR, consistent with their resistance to hormonal therapy. They are post-mitotic cells but are malignant and part of the tumor.
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Affiliation(s)
- Jiaoti Huang
- Department of Pathology, University of Rochester Medical Center, Rochester, New York 14642, USA.
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20
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Wang Y, Harada M, Yano H, Ogasawara S, Takedatsu H, Arima Y, Matsueda S, Yamada A, Itoh K. Prostatic acid phosphatase as a target molecule in specific immunotherapy for patients with nonprostate adenocarcinoma. J Immunother 2006; 28:535-41. [PMID: 16224270 DOI: 10.1097/01.cji.0000175490.26937.22] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Prostatic acid phosphatase (PAP) is one of the prostate-related antigens that are applicable to specific immunotherapy for patients with prostate cancer. In this study, we determined whether or not PAP could be a target molecule in specific immunotherapy for patients with nonprostate cancer. A variety of adenocarcinoma cell lines were examined for their PAP expression at the mRNA and protein levels by reverse transcription polymerase chain reaction and western blot analysis, respectively. Considerable percentages of colon, gastric, and breast cancer cell lines were found to be positive for PAP at both the mRNA and the protein levels. The PAP expression in cancer tissues was also confirmed by immunohistochemical staining. In addition, we examined whether cancer-reactive cytotoxic T lymphocytes (CTLs) could be induced from peripheral blood mononuclear cells (PBMCs) of human leukocyte antigen (HLA) A24+ nonprostate cancer patients by in vitro stimulation with a PAP peptide. As a result, tumor-specific CTLs could be induced from the PBMCs of HLA-A24+ colon and gastric cancer patients. Their cytotoxicity against HLA-A24+ cancer cells was dependent on PAP peptide-specific and CD8+ T cells. These findings indicate that PAP could be a target molecule in specific immunotherapy for patients with nonprostate adenocarcinomas including colon and gastric cancers.
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Affiliation(s)
- Yi Wang
- Cancer Vaccine Development Division, Kurume University Research Center for Innovative Cancer Therapy, Kurume, Japan
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21
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Couvelard A. Tumeurs endocrines gastro-intestinales : particularités morphologiques et clinico-pathologiques. Ann Pathol 2005; 25:499-509. [PMID: 16735975 DOI: 10.1016/s0242-6498(05)86163-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Gastro-intestinal endocrine tumors constitute a heterogeneous group of tumors. Their clinical features, functional properties, and clinical course differ according to their site of origin. From a practical point of view, several topographical groups may be distinguished: (a) stomach, (b) duodenum and proximal jejunum, (c) ileum and caecum, (d) appendix, (a) colon and rectum. In each of these groups, a certain degree of tumor heterogeneity persists, especially between colon and rectal tumors, which would be better considered apart. In this review, we will describe the main functional, morphological and evolutive features of endocrine tumors in each of the topographical groups currently recognized.
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Affiliation(s)
- Anne Couvelard
- Service d'Anatomie Pathologique, Hôpital Beaujon, APHP - Université Paris 7, 100 Boulevard du Général Leclerc, 92110 Clichy.
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22
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Varma M, Jasani B. Diagnostic utility of immunohistochemistry in morphologically difficult prostate cancer: review of current literature. Histopathology 2005; 47:1-16. [PMID: 15982318 DOI: 10.1111/j.1365-2559.2005.02188.x] [Citation(s) in RCA: 96] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Varma M & Jasani B (2005) Histopathology47, 1-16 Diagnostic utility of immunohistochemistry in morphologically difficult prostate cancer: review of current literatureImmunohistochemistry is widely used to distinguish prostate cancer from benign mimics and to establish the prostatic origin of poorly differentiated carcinoma. We critically review the recent advances in prostate cancer immunohistochemistry, including the introduction of newer basal cell markers such as p63 and the discovery of the overexpression of alpha-methylacyl coenzyme A racemase (AMACR) in prostate cancer. The description of newer urothelial markers to aid the distinction of prostate cancer from urothelial carcinoma is also presented together with refinements in the quality control of PSA and PSAP immunostaining. Although AMACR is a useful immunohistochemical marker for prostate cancer, it has significant limitations. These limitations are discussed and the need for interpreting AMACR immunoreactivity in the appropriate morphological context and in conjunction with basal call markers is emphasized. We also describe the utility of an immunohistochemical panel composed of PSA, PSAP and high molecular weight cytokeratin for distinguishing poorly differentiated prostate cancer from high-grade urothelial carcinoma. A morphological differential diagnosis based selection of immunohistochemical markers is highlighted as a novel approach in the diagnosis of prostate cancer in routine surgical pathology practice.
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Affiliation(s)
- M Varma
- Department of Pathology, University Hospital of Wales and School of Medicine, Cardiff, Wales, UK.
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23
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Guy L, Bégin LR, Oligny LL, Brock GB, Chevalier S, Aprikian AG. Searching for an intrinsic neuroendocrine cell in the kidney. An immunohistochemical study of the fetal, infantile and adult kidney. Pathol Res Pract 2000; 195:25-30. [PMID: 10048091 DOI: 10.1016/s0344-0338(99)80090-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
The pathogenesis of primary renal carcinoid tumor is unknown. One hypothesis has implied derivation from a yet unrecognized intrinsic neuroendocrine cell in the renal parenchyma/hilum either as a minute endocrineparacrine constituent or resulting from entrapped/misplaced progenitor cells of the so-called dispersed neuroendocrine system during organogenesis. Immunohistochemical staining for chromogranin and serotonin was systematically performed on a whole-mount and geographically mapped normal adult kidney, kidneys from 15 fetuses (age range: 15 to 38 weeks), and renal specimens from 18 infants/children (age range: 7 days to 123 months). Minute paraganglion nests (composed of chromogranin positive/serotonin negative chief cells and S-100 protein positive dendritic cells) were incidentally detected within the renal hilum primitive stroma (unilaterally) of two fetuses at 22 and 26 weeks. Sequestration and persistence of such paraganglion nests during renal growth and maturation would offer a basis for the rare occurrence of extra-adrenal paraganglioma involving the renal hilum/pedicle. Otherwise, no neuroendocrine cell was detected within the renal parenchyma or hilum, therefore not validating/sustaining the aforementioned hypothesis in the pathogenesis of renal carcinoid tumor.
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Affiliation(s)
- L Guy
- Department of Urology, Montreal General Hospital Research Institute, McGill University, Canada
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24
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Abstract
Carcinoid tumours are enigmatic, slow growing malignancies which occur most frequently (74%) in the gastrointestinal tract. In recent years, it has become apparent that the term 'carcinoid' represents a wide spectrum of different neoplasms originating from a variety of different neuroendocrine cell types. Carcinoid lesions are usually identified histologically by their affinity for silver salts, by general neuroendocrine markers, or more specifically by immunocytochemistry using antibodies against their specific cellular products. Within the gut, the most frequent sites are the small bowel (29%), the appendix (19%) and rectum (13%). Clinical manifestations are often vague or absent. Nevertheless, in approximately 10% of patients the tumours secrete bioactive mediators which may engender various elements of characteristic carcinoid syndrome. In many instances the neoplasms are detected incidentally at the time of surgery for other gastrointestinal disorders. The tendency for metastatic spread correlates with tumour size, and is substantially higher in lesions larger than 2.0 cm. An association with noncarcinoid neoplasms is ascribed in 8-17% of lesions. Treatment consists of radical surgical excision of the tumour, although gastric (type I and II) and rectal carcinoids may be managed with local excision. Overall 5-year survival is excellent for carcinoids of the appendix (86%) and rectum (72%), whereas small intestinal (55%), gastric (49%) and colonic carcinoids (42%) exhibit a far worse prognosis.
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Affiliation(s)
- J M Läuffer
- Gastrointestinal Pathobiology Research Group, Yale University School of Medicine, New Haven, Connecticut, USA
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Anton RC, Schwartz MR, Kessler ML, Cagle PT. Metastatic carcinoma of the prostate mimicking primary carcinoid tumor of the lung and mediastinum. Pathol Res Pract 1998; 194:753-8. [PMID: 9842633 DOI: 10.1016/s0344-0338(98)80064-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Although prostatic carcinomas rarely present as intrathoracic metastases, they may occasionally exhibit clinical and radiographic findings suggestive of a primary pulmonary carcinoid, particularly when they have a cribriform pattern. This report describes three patients who presented with lung and mediastinal neoplasms initially diagnosed as primary carcinoid tumors. These tumors were later proven to be metastatic prostate carcinoma by the use of immunohistochemical studies, including stains for chromogranin, carcinoembryogenic antigen and prostate specific antigen. These findings emphasize the importance of considering metastatic prostate adenocarcinoma in the differential diagnosis of carcinoid or neuroendocrine carcinoma with a cribriform pattern.
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Affiliation(s)
- R C Anton
- Department of Pathology, Baylor College of Medicine, Houston, Texas 77030, USA
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Bégin LR, Guy L, Jacobson SA, Aprikian AG. Renal carcinoid and horseshoe kidney: a frequent association of two rare entities--a case report and review of the literature. J Surg Oncol 1998; 68:113-9. [PMID: 9624041 DOI: 10.1002/(sici)1096-9098(199806)68:2<113::aid-jso8>3.0.co;2-9] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
We report the case of a primary renal carcinoid tumor associated with a horseshoe malformation in a 43-year-old man who presented with testicular pain. The tumor was centrally located and purely solid and had features ascribed to hindgut neuroendocrine neoplasia. The relative risk of developing a carcinoid tumor in a horseshoe kidney is estimated to be x82.
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Affiliation(s)
- L R Bégin
- Department of Pathology, McGill University, Sir Mortimer B. Davis Jewish General Hospital, Montreal, Canada
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Abstract
The identity and genetic origins of the nonspecific orthophosphate monoesterases with an acid pH optimum--the acid phosphatases--are now becoming clear. They form a family of genetically distinct isoenzymes, many of which show significant posttranslational modification. Four true isoenzymes exist. The erythrocytic and lysosomal forms show widespread distribution and are expressed in most cells; in contrast, the prostatic and macrophagic forms have a more limited expression. The erythrocytic and macrophagic forms are distinguished from the others in resisting inhibition by dextrorotatory tartrate. The prostatic form has long been used as a marker for prostatic cancer and the macrophagic forms have been linked with miscellaneous disorders, notably increased osteolysis, Gaucher's disease of spleen, and hairy cell leukemia, whereas the normal levels of intravesical lysosomal acid phosphatase in I cell disease pointed the way toward the mechanisms underlying its intracellular processing.
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Affiliation(s)
- D W Moss
- Department of Chemical Pathology, Royal Postgraduate Medical School, London, U.K
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28
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Abstract
We present a case of isolated carcinoid tumor of the sacrum and highlight the unusual nature of this lesion. The histopathology suggests hindgut cause, and we discuss the possibility of an underlying congenital tailgut cyst. We review the pathology of these rare anomalies with reference to embryological development and known instances of carcinoid focus. We also present previous reports of sacral carcinoid.
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Affiliation(s)
- C L Schnee
- Division of Neurological Surgery, Hospital of the University of Pennsylvania, Philadelphia
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29
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30
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31
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Abstract
BACKGROUND Strumal carcinoids (SC) are ovarian tumors containing thyroid parenchyma admixed with carcinoid elements. Microscopically, the carcinoid component of SC usually presents a ribbon or trabecular pattern similar to the pattern exhibited by hindgut carcinoids. The authors designed an immunohistochemical study to ascertain further similarities of the carcinoid component of SC to rectal carcinoids. METHODS Five cases of SC were examined by light microscopic study with hematoxylin and eosin and immunoperoxidase staining with a group of neurohormonal peptides, thyroglobulin, prostatic acid phosphatase, and prostate specific antigen. RESULTS All tumors were positive for thyroglobulin, chromogranin, prostatic acid phosphatase (PAP), and glucagon. They were consistently negative for prostate specific antigen and variably positive to the other antibodies. CONCLUSIONS The consistent positivity of the carcinoid component of SC to PAP immunostaining is a further similarity of these tumors to rectal carcinoids, in which positive immunostaining to PAP has been observed. The similarity is not well understood, however, as all evidence points to the origin of SC from germ cells in mature cystic teratomas without any embryologic relationship to the hindgut.
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Affiliation(s)
- J Sidhu
- Department of Surgical Pathology, University of Texas Medical Branch, Galveston 77555-0588
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Abstract
Five patients with ovarian carcinoid who had severe constipation for a long period preoperatively showed marked reduction of this symptom postoperatively. Because this phenomenon was believed to be caused by some biologically active substance rather than a mechanical effect of the tumor, reactivity to 17 amine and peptide hormones was studied immunohistochemically in these patients. Numerous peptide YY (PYY)-positive cells were detected, with PYY-positive cells representing more than 50% of all carcinoid tumor cells in each patient. PYY, which has a pharmacologic inhibitory action on intestinal motility, was presumably the cause of the constipation in these patients.
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Affiliation(s)
- T Motoyama
- Department of Pathology, Niigata University School of Medicine, Japan
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Bilhartz DL, Tindall DJ, Oesterling JE. Prostate-specific antigen and prostatic acid phosphatase: biomolecular and physiologic characteristics. Urology 1991; 38:95-102. [PMID: 1715106 DOI: 10.1016/s0090-4295(05)80066-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
PSA is a 34-kd 240-amino acid glycoprotein produced by the prostatic epithelial cells. It is a member of the glandular kallikrein gene family and has a high sequence homology with human glandular kallikrein (hGK-1). PSA is a serine protease and has chymotrypsin-, trypsin-, and esterase-like activities. It is secreted into the seminal fluid where it degrades two seminal vesicle proteins that are important components of the semen coagulum, thus playing an important role in semen liquefaction. The production of PSA protein appears to be under the control of circulating androgens acting through the androgen receptor. Therefore, the significance of a low serum PSA value in a patient who has undergone previous antiandrogen therapy may not be the same as that for a patient who has not received endocrine treatment.
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Affiliation(s)
- D L Bilhartz
- Department of Urology, Mayo Clinic, Rochester, Minnesota
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Kamoshida S, Tsutsumi Y. Extraprostatic localization of prostatic acid phosphatase and prostate-specific antigen: distribution in cloacogenic glandular epithelium and sex-dependent expression in human anal gland. Hum Pathol 1990; 21:1108-11. [PMID: 1699876 DOI: 10.1016/0046-8177(90)90146-v] [Citation(s) in RCA: 101] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Immunoreactivities of prostatic acid phosphatase (PACP) and prostate-specific antigen (PSA) were demonstrated in normal anal glands of males (11 of 25) and urethral glands of both sexes (six of six), by indirect immunoperoxidase staining. These prostatic antigens were colocalized in nonmucous epithelial cells. In the anal gland, PACP and PSA were distributed exclusively in acinus-forming, tall columnar cells, while columnar cells with brush borders, goblet cells, and transitional cells in the duct were negative. The anal glands from 20 females were devoid of such acinar structures and were negative for the antigens. Normal urinary bladder mucosa (n = 17) lacked immunoreactivity. A few endocrine-type cells, which showed PACP immunoreactivity but no PSA staining, were identified in normal rectal mucosa (n = 17) and were found rarely in the anal gland. The results of the present study suggest (1) that the development of acinar cells in the anal gland is an androgen-dependent phenomenon, and (2) that the ability to express PACP and PSA is a feature common to cloacogenic glandular epithelium.
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Affiliation(s)
- S Kamoshida
- Laboratory of Pathology, Isehara Kyodo Hospital, Japan
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Abstract
Eighty-four carcinoids of the colon and rectum were studied with emphasis on prognostic features, immunohistochemical characteristics, and pitfalls in diagnosis. Follow-up data were available on 35 patients. Tumors with adenocarcinomatous components, or those resembling small cell carcinomas of the lung, were excluded. Eighty-one tumors were in the rectum and three tumors were in the distal sigmoid colon. Neuron-specific enolase, chromogranin, and Leu-7 were positive in 87%, 58%, and 53% of the tumors, respectively. Hormones were positive in the following percentages: serotonin, 45%; pancreatic polypeptide, 46%; glucagon, 10%; gastrin, 3%; somatostatin, 3%; adrenocorticotrophic hormone, 1%; cholecystokinin, 0%; calcitonin, 0%; and insulin, 0%. Many tumors elaborated more than one hormone. Fifty-five percent of the tumors were argyrophil and 28% were argentaffin. Carcinoembryonic antigen was present in 24% of the tumors; 82% of the tumors contained prostatic acid phosphatase. Three patients had liver metastases; their tumors ulcerated, invaded muscularis propria, and had more than 2 mitoses per 10 high-power fields (HPF). One patient with a 2.5-cm tumor without mitoses had regional lymph node metastases. All non-metastasizing tumors had less than one mitosis in 10 HPF. We conclude that large bowel carcinoid tumors are essentially limited to the rectum and sigmoid, that they are indolent if mitotically inactive and smaller than 2 cm, and that most show production of a selected group of endocrine markers.
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Affiliation(s)
- B H Federspiel
- Department of Gastrointestinal Pathology, Armed Forces Institute of Pathology, Washington, D.C. 20306-6000
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Kimura N, Sasano N, Namiki T, Nakazato Y. Coexpression of cytokeratin, neurofilament and vimentin in carcinoid tumors. VIRCHOWS ARCHIV. A, PATHOLOGICAL ANATOMY AND HISTOPATHOLOGY 1989; 415:69-77. [PMID: 2472033 DOI: 10.1007/bf00718606] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The immunohistochemical expression of intermediate filaments was investigated in 56 carcinoid tumors from 50 cases including 31 rectal and 25 non-rectal sites. Cytokeratin was the most frequently expressed in 55 of the tumours. Only one tumour of the stomach was negative for cytokeratin. Neurofilament (68 kd and 160 kd) was positive in 25 (44.6%) tumours with no preferential pattern of expression in particular tumours. Vimentin was positive in 18 out of the 31 rectal carcinoids (58%), and 3 of the 25 non-rectal carcinoids (12%). There was a significant difference in vimentin immunoreactivity between rectal and non-rectal carcinoids. The coexpression of cytokeratin and neurofilament was 44.6% and that of cytokeratin and vimentin was 37.5%. The coexpression of all three types of intermediate filament was 35.5% in rectal carcinoids, but 8% in non-rectal carcinoids. The present study revealed coexpression of cytokeratin, neurofilament and vimentin in carcinoids and an especially high incidence of vimentin expression in those of rectal origin.
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Affiliation(s)
- N Kimura
- Department of Pathology, Tohoku University School of Medicine, Sendai, Japan
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Kimura N, Sasano N, Yamada R, Satoh J. Immunohistochemical study of chromogranin in 100 cases of pheochromocytoma, carotid body tumour, medullary thyroid carcinoma and carcinoid tumour. VIRCHOWS ARCHIV. A, PATHOLOGICAL ANATOMY AND HISTOPATHOLOGY 1988; 413:33-8. [PMID: 3131955 DOI: 10.1007/bf00844279] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Neuroendocrine cells have histologically common features represented by argyrophilic cytoplasm containing neuroendocrine granules. Neuroendocrine granules are composed of various kinds of peptide hormones, amines, carrier proteins and ATP. Although various kinds of peptide hormones have been detected in neuroendocrine tumours, a peptide hormone has not been required as a standard marker for these tumours. Chromogranin is a purified protein which binds catecholamines specifically and is recognized as a carrier protein. We carried out an immunohistochemical study of chromogranin immunoreactivity in 100 neuroendocrine tumours including pheochromocytomas, carotid body tumours, medullary thyroid carcinomas and carcinoid tumours. Marked immunoreactivity was observed in 85% of carcinoid tumours and 100% of the other tumour types. A non-functioning paraganglioma and a malignant carcinoid tumour without any other detectable marker also showed strong immunoreactivity to chromogranin. Chromogranin immunoreactivity is a useful tool for neuroendocrine tumours.
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Affiliation(s)
- N Kimura
- Department of Pathology, Tohoku University School of Medicine, Sendai, Japan
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