Comparative analysis of three- and two-antibody cocktails to AMACR and basal cell markers for the immunohistochemical diagnosis of prostate carcinoma

Sixty-six prostate needle biopsies were analysed prospectively. Serial sections were immunostained with the two- and three- antibody cocktails. Blinded slides were assessed individually by two pathologists and sensitivity, specificity and kappa statistics were calculated.Both antibody cocktails contributed to the detection of prostate carcinoma in needle biopsies. There was an acceptable level of agreement between the pathologists for both the cocktails. Sensitivity was similar for one pathologist comparing both the cocktails (76.4% and 75.7%), but was slightly lower comparing the three-antibody with the two-antibody cocktail for the other pathologist (66.6% vs. 77.4%, respectively). Higher specificity values of 90.3% were achieved by both pathologists using three-antibody as compared with two-antibody cocktails (68.7% and 71.8%).Antibody cocktails are important in diagnosing prostate carcinoma in needle biopsies. Adding an extra basal cell marker to the traditional two-antibody cocktail improves the specificity of detecting prostate carcinoma in limited needle biopsy material, and should be considered for routine diagnostic use.The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2492231327330327 webciteProstate cancer is globally the second most frequently diagnosed cancer and the sixth leading cause of cancer death in males, accounting for 14% (903,500) of new cancer cases and 6% (258,400) of cancer deaths in males in 2008 [1]. Incidence rates vary by more than 25-fold worldwide, with the highest rates recorded primarily in the developed countries of Oceania, Europe, and North America, largely because of the widespread use of prostate-specific antigen (PSA) testing and subsequent prostate biopsy in these regions [1].Histological diagnosis of prostatic cancer is usually based on histological evaluation of prostatic needle biopsies. This can be challenging, particularly when the malignant tissue is limited and is ad