acid-phosphatase and Carcinoma-in-Situ

Our knowledge of prostate cancer is less well-defined than our knowledge of cancers of other organs. In the colon, for example, morphological criteria to identify carcinomas in situ and some putative preneoplastic lesions are clear; phenotypic differences in the expression of enzymes and antigens are documented in experimental models and are starting to be defined in humans. Experimental models of cancer of the liver and colon show evidence that "enzyme-altered foci" are preneoplastic. In these organs, the "normal" context is much clearer than in the prostate. In contrast, in the prostates of men in the same age range as those who develop prostate cancer, morphological aberrations are almost always present, diverse, and poorly understood. Murphy and Gaeta said that, "in the study of prostatic disease..., almost every aspect remains controversial...[and].... many of the 'known facts' concerning prostatic disease are poorly documented..." While being aware that the definitions of all benign and malignant lesions of the prostate are based on complex morphological criteria which must form the contemporary context for comparisons, our laboratory is searching for markers that will permit the identification of putative preneoplastic lesions in the prostate. In our opinion, these changes will not be found most efficiently, if they are present at all, in long established cell lines, advanced carcinomas, or serially transplantable xenografts of primary prostatic carcinomas. Our preliminary data suggest that several enzyme histochemical and immunohistochemical approaches are worthy of study. Markers that show promise include acid phosphatase, 5'-nucleotidase, leucine aminopeptidase, and CD44.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: 5'-Nucleotidase; Acid Phosphatase; Adult; Aged; Aged, 80 and over; Aging; Animals; Antigens, CD; Biomarkers, Tumor; Carcinoma in Situ; Carrier Proteins; Humans; Hyaluronan Receptors; Leucyl Aminopeptidase; Male; Middle Aged; Organ Size; Precancerous Conditions; Prostate; Prostatic Neoplasms; Receptors, Cell Surface; Receptors, Lymphocyte Homing

For primary bladder tumors, distinguishing urothelial carcinoma (UC) invading the fibromuscular stroma of the prostate (pT4a) from in situ UC involving prostatic ducts can be difficult. Immunohistochemical markers (cytokeratin [CK]5/6, CK5, CK7, CK20, p53, p63, high-molecular-weight keratin [HMWK], androgen receptor, prostate-specific antigen [PSA], prostate specific acid phosphatase [PSAP], laminin, CD44s, CD141) were assessed for their usefulness in determining depth of UC invasion in the prostate. In cystoprostatectomy specimens containing in situ UC in prostatic ducts, both CK5/6 and CK5 clearly differentiated prostatic basal cells from in situ UC. The remaining markers were not effective in determining depth of tumor invasion. Double-stain combinations CK7/CK5 and p53/CK5 were performed and robustly color contrasted in situ tumor from surrounding basal cells. The use of CK5/6, CK5, CK7/CK5, or p53/CK5 is recommended to assist in determining the depth of UC invasion in the prostate when histologic findings are equivocal.

Topics: Acid Phosphatase; Biomarkers, Tumor; Carcinoma in Situ; Humans; Hyaluronan Receptors; Keratin-20; Keratin-5; Keratin-6; Keratin-7; Laminin; Male; Neoplasm Invasiveness; Neoplasm Staging; Prostate-Specific Antigen; Prostatic Neoplasms; Tumor Suppressor Protein p53; Urinary Bladder Neoplasms; Urothelium

Topics: Acid Phosphatase; Adenocarcinoma; Carcinoma in Situ; Carcinoma, Adenoid Cystic; Carcinoma, Basal Cell; Cervix Uteri; Choristoma; Diagnosis, Differential; Female; Humans; Male; Middle Aged; Prostate; Prostate-Specific Antigen; Protein Tyrosine Phosphatases; Uterine Cervical Diseases; Uterine Cervical Neoplasms

Paneth cell-like change (PCLC) of the prostatic glandular epithelium was focally observed in one case of normal glandular epithelium, two cases of glandular and stromal hyperplasia, one case of prostatic intraepithelial neoplasia, and four cases of prostatic adenocarcinoma. The distinctive cells were characterized by bright, eosinophilic cytoplasmic granules on routine hematoxylin and eosin-stained material. The cytoplasmic granules in the benign prostatic epithelium were periodate-Schiff's procedure (PAS)-positive and diastase resistant and immunohistochemically negative for lysozyme, neuron-specific enolase, chromogranin, and serotonin. The eosinophilic granules in the prostatic intraepithelial neoplasia and adenocarcinoma cases were immunohistochemically positive for chromogranin, serotonin, and neuron-specific enolase, and negative for lysozyme. By electron microscopy the eosinophilic granules represented exocrine-like or lysosomal-like vesicles in the benign epithelium and neuro-endocrine granules in the malignant epithelium. The lesion represents a prostatic epithelial PCLC rather than a Paneth cell metaplasia. PCLC is the common histological manifestation of two different phenomena: (a) a PAS-positive and diastase-resistant eosinophilic cytoplasmic granular change in benign prostatic epithelium, and (b) endocrine differentiation with neuroendocrine granules in dysplastic and malignant prostatic epithelia. The importance of recognizing PCLC lies in its differentiation from other possible prostatic cytoplasmic inclusions.

Topics: Acid Phosphatase; Adenocarcinoma; Aged; alpha 1-Antichymotrypsin; Antigens, Neoplasm; Carcinoma in Situ; Cell Transformation, Neoplastic; Chromogranins; Cytoplasmic Granules; Epithelium; Humans; Immunohistochemistry; Male; Microscopy, Electron; Middle Aged; Muramidase; Phosphopyruvate Hydratase; Prostate; Prostate-Specific Antigen; Prostatic Hyperplasia; Prostatic Neoplasms; Serotonin

Carcinomas of the rat prostate induced by a single injection of N-methyl-N-nitrosourea, 7,12-dimethylbenz(a)anthracene, and 3,2'-dimethyl-4-aminobiphenyl, after sequential treatment with cyproterone acetate and testosterone propionate, were evaluated as potential animal models for prostatic cancer. All ten carcinomas examined were located in the dorsolateral prostate region and did not involve the distal parts of the seminal vesicles and coagulating glands. The incidence of urinary obstruction leading to the animals' death was 6 of 10 rats, and metastases in the lung, abdominal lymph nodes, and/or liver also occurred in 6 of 10 rats. The tumors were invasive adenocarcinomas, showing frequent perineural invasion and a variable degree of differentiation. There were ultrastructural similarities with human prostatic carcinomas, such as intracellular lumina. Plasma acid phosphatase was increased. Enzyme histochemical analysis revealed similarities with the Dunning R3327H and -HI prostatic carcinomas but was not helpful in determining the site of origin of the tumors. The gross and microscopic appearance of the tumors and the observation of preneoplastic lesions exclusively located in the dorsolateral prostate suggest this lobe as site of origin of the carcinomas. Preneoplastic lesions (n = 9) included atypical hyperplasias (n = 5) and lesions with all histological characteristics of carcinoma except for local invasion and metastases, which were classified as carcinoma in situ (n = 4). Although androgen sensitivity could not be assessed, the observed characteristics of the tumors [their long latency time (46-80 weeks), the presence of preneoplastic lesions, and the short duration of the treatment, leaving the animals intact] all indicate that the present approach is a valid animal model for the study of prostatic carcinogenesis.

Topics: 9,10-Dimethyl-1,2-benzanthracene; Acid Phosphatase; Adenocarcinoma; Aminobiphenyl Compounds; Animals; Carcinoma in Situ; Cell Differentiation; Histocytochemistry; Hyperplasia; Male; Methylnitrosourea; Microscopy, Electron; Neoplasm Metastasis; Precancerous Conditions; Prostatic Neoplasms; Rats

Twenty prostate glands from patients with either high-grade papillary tumors (19 patients, 15 of whom also had peripheral carcinoma in situ) or multifocal carcinoma in situ (1 patient) of the bladder who underwent cystoprostatectomy were studied histologically by mapping. Prostatic duct involvement by urothelial carcinoma was noted in nine patients, two with extensive involvement and seven with focal involvement confined to periurethral ducts. Carcinoma in situ of the bladder was observed in each of the nine patients and intraepithelial permeation appeared to be the predominant manner of spread of cancer cells into the prostate. The prostatic involvement was clinically silent and it may be a potential source of failure of conservative modalities of treatment of high-grade bladder cancer. A routine diagnostic transurethral prostatic biopsy may be recommended in the workup of patients with carcinoma in situ and high-grade carcinomas of the bladder. An incidental observation was the presence of 14 occult prostatic adenocarcinomas.

Topics: Acid Phosphatase; Adenocarcinoma; Aged; Carcinoma in Situ; Ejaculatory Ducts; Histocytochemistry; Humans; Immunoenzyme Techniques; Male; Middle Aged; Neoplasm Invasiveness; Neoplasms, Multiple Primary; Prostate; Prostatectomy; Prostatic Neoplasms; Urethral Neoplasms; Urinary Bladder Neoplasms

Topics: Acid Phosphatase; Adult; Aged; Carcinoma in Situ; Carcinoma, Squamous Cell; Female; Histocytochemistry; Humans; Middle Aged; Uterine Cervical Neoplasms; Vaginal Smears