Abstract
Premalignant lesions of prostate are characterized by abnormal changes in the epithelial lining of the acini and ducts. Prostatic intraepithelial neoplasia (PIN) and atypical adenomatous hyperplasia (AAH) are two commonly encountered premalignant lesions on histopathological examination. Early detection and treatment of these lesions can improve patient’s prognosis. The objectives of this study were to identify the histomorphological features of various on lesions of prostate, to know the association of premalignant lesion with adenocarcinoma prostate and to study expression of p63 and AMACR markers in benign, premalignant and malignant lesions of prostate. This was a prospective study carried out for two years with a total of 175 cases included. Maximum number of cases was in age group of 60-69 years. Out of 175 cases, 101 cases of BPH, 22 cases of LGPIN, 26 cases of HGPIN, 11 cases of AAH and 15 cases of adenocarcinoma were noted. Immunohistochemistry with p63 showed partial or complete positivity in cases of BPH, LGPIN, HGPIN and AAH, while complete negativity noted in adenocarcinoma cases. Immunostaining with AMACR showed complete negativity in 100% cases of BPH and LGPIN. 69% cases of HGPIN and 72% cases of AAH showed positivity while rest of the cases were negative for AMACR, adenocarcinoma cases showed complete and strong positivity with AMACR. 60% cases of HGPIN, 26.6% AAH and 13.4% cases of LGPIN are seen in association with adenocarcinoma. To conclude, PIN, especially HGPIN is most often observed premalignant lesion, in association with adenocarcinoma, LGPIN and AAH showed a weaker association with adenocarcinoma. Application of IHC helps in differentiating benign, premalignant and malignant lesions of the prostate, thereby arriving at an early and accurate diagnosis.