Table of Contents
What is PIN 4 stain?
It is a triple stain that is useful in distinguishing prostatic adenocarcinoma (variable AMACR/P504S red cytoplasmic staining with a lack of basal cell p63+HMWK brown staining) from the benign mimickers (with preserved basal cell brown staining of p63+HMWK and generally lack of red cytoplasmic staining of AMACR/P504S).
What is PIN 4?
Test Description. This test uses a combination of several antibodies (applied to a single slide) that differentially stain for basal cells and neoplastic cells in the prostate: P504S stains prostate adenocarcinoma, whereas p63 and the high molecular weight cytokeratins stain benign prostate basal epithelial tissue.
What is a prostate triple stain?
This test uses a combination of several antibodies (applied to a single slide) that differentially stain for basal cells and neoplastic cells in the prostate: P504S stains prostate adenocarcinoma, whereas p63 and the high molecular weight cytokeratins stain benign prostate basal epithelial tissue.
What is Hmwck?
In recent period, basal cell markers high molecular weight cytokeratin (HMWCK), P63 and prostate biomarker AMACR have been used as adjuvant to morphology in diagnostically challenging cases with a very high sensitivity and specificity.
Is high-grade intraepithelial neoplasia cancerous?
HGPIN refers to proliferation of prostate glandular epithelial cells that display significant cytological atypia within the confines of prostatic ducts and acini. It has been accepted as the main precursor lesion to invasive prostate carcinoma.
What is high-grade prostate carcinoma?
High-grade prostatic intraepithelial neoplasia (high-grade PIN) is a pre-cancer of the prostate. It is not important in someone who already has prostate cancer. In this case, the term ‘high-grade’ refers to the PIN and not the cancer, so it has nothing to do with the Gleason score or how aggressive your cancer is.
How is HGPIN treated?
No therapy is indicated for HGPIN as an isolated finding. Because the risk of cancer after a biopsy diagnosis of HGPIN in more recent studies is decreasing, the current recommendation for repeat biopsy may change in the near future.
What does focal high grade prostatic intraepithelial neoplasia mean?
HGPIN refers to proliferation of prostate glandular epithelial cells that display significant cytological atypia within the confines of prostatic ducts and acini. 2. It has been accepted as the main precursor lesion to invasive prostate carcinoma.
What does AMACR positive mean?
Alpha-methylacyl-CoA-racemase (AMACR) is a recently discovered tumor marker whose expression is significantly upregulated in prostate cancer.
What is a multiplex antibody stain procedure?
It entails rounds of four-color indirect immunofluorescence, image acquisition, and removal (stripping) of the antibodies, before another stain is applied. The images are digitally registered and the autofluorescence is subtracted.
What does Amacr positive mean?
How do you treat a high-grade PIN?
Current treatment options
- Androgen-deprivation therapy. Some studies of men with both high-grade PIN and prostate cancer who underwent treatment for the cancer have concluded that androgen-deprivation therapy reduced the extent of high-grade PIN.
- Finasteride (Proscar).
- Other options.
- Originally published Oct.
What is PIN in the prostate?
Prostatic intraepithelial neoplasia (PIN) is a condition “defined by neoplastic growth of epithelial cells within preexisting benign prostatic acini or ducts.”3 Because PIN satisfies almost all the requirements for a premalignant condition, high-grade PIN (HGPIN) is widely accepted as a precursor to prostate cancer.
Can a PI RADS 4 prostate lesion be benign?
Background: The detection rate of clinically significant prostate cancer has improved with the use of multiparametric magnetic resonance imaging (mpMRI). Yet, even with MRI-guided biopsy 15%-35% of high-risk lesions (Prostate Imaging-Reporting and Data System [PI-RADS] 4 and 5) are histologically benign.
What is the treatment for high-grade prostatic intraepithelial neoplasia?
In this setting, some doctors will recommend treatment, such as surgery or radiation, since intraductal carcinoma is typically associated with high-grade prostate cancer. Other doctors may choose to do a repeat biopsy to try to confirm the high-grade cancer before starting treatment.
What is Amacr in a biopsy?
What is Racemase staining?
Positive racemase staining converts an atypical diagnosis, based on suspicious histology and negative basal cell marker stains, to cancer in approximately 10% of cases thought to be atypical by contributing pathologists, and in approximately 50% of cases thought to be atypical by a specialist in genitourinary pathology …
Can you stain with two primary antibodies at the same time?
The use of multiple antibodies in a single experiment can provide useful information to researchers. Co-staining with multiple antibodies and cellular dyes is a simple, low-content form of multiplex analysis.
What is the diagnostic utility of PIN4?
Diagnostic Utility. PIN4 consists of a cocktail of three antibodies, including AMACR(P504S), p63, and high molecular weight cytokeratin. It is a triple stain that is useful in distinguishing prostatic adenocarcinoma (variable AMACR/P504S red cytoplasmic staining with a lack of basal cell p63+HMWK brown staining) from the benign mimickers…
What antibodies are used in the triple stain P504S?
The following antibodies are utilized in this triple stain: p504S; p63 and 34βE12. This test is performed as a stain and return (technical) service only. The American Medical Association Current Procedural Terminology (CPT) codes published in ARUP’s Laboratory Test Directory are provided for informational purposes only.
How many slides are needed for a PIN4 test?
Formalin-fixed, paraffin embedded tissue block or cell block, or 1 unstained charged slide for each test requested plus 3-4 additional unstained slides cut at 4 microns. Adequate space on each slide for control tissue is required. PIN4 consists of a cocktail of three antibodies, including AMACR (P504S), p63, and high molecular weight cytokeratin.