Diagnostic and Prognostic Role of Prostate-Specific Antigen Immunologic Staining in Prostate Cancer

Abstract

Background: Prostatic adenocarcinoma is the second leading cause of death in males due to cancer. The prostate-specific antigen (PSA) serum level is the first marker for screening such patients. Objectives: The present study evaluated the comparison between the degree of staining of the PSA marker and some factors in the prognosis of prostate cancer. Methods: The current cross-sectional study was performed on 97 tissue blocks from patients with prostate adenocarcinoma collected in 2019-2020 from the Pathology Department of Golestan Ahvaz Hospital archives. Clinical information such as age, tumor size, grade of tumor, lymph node involvement, and vascular and perineural invasion was extracted from patients' pathology reports and recorded on a checklist. Then, PSA apical and intensity staining was studied using immunohistochemistry. Results: The mean age of patients was 72.76 ± 8.19 years. The mean serum PSA level was 39.2 ± 8.90. In the present study, the highest PSA staining intensity in the samples was related to grade 1 with a frequency of 39 (40.2%), and then it was related to grade 4 with a frequency of 38 (39.2%), while the lowest frequency of staining intensity was related to grade 2 was with a frequency of 9 (9.3%). Regarding PSA apical staining, 58 samples (59.8%) were positive, and 39 (40.2%) were negative. A statistically significant comparison was shown between Gleason scoring and PSA apical staining (P < 0.001). The results indicate that increasing Gleason scoring decreases the staining intensity, and this correlation is significant (P < 0.05). The mean age in samples with positive staining of apical marker PSA is lower than in samples with negative staining of apical marker PSA but is not statistically significant (P = 0.38). In contrast, the serum level of the PSA marker is statistically significantly higher in samples with positive staining of apical marker PSA than in samples with negative staining of PSA (P < 0.001). According to the Spearman correlation coefficient test, the intensity of staining of the PSA marker decreases with age, and this correlation is significant (P = 0.032). However, according to the Spearman correlation coefficient test, staining intensity increases with increasing serum PSA level, and this correlation is statistically significant (P < 0.001). Conclusions: It is also suggested that in future studies with a larger sample size, the comparison between apical marker expression and PSA marker staining intensity with clinicopathological factors, survival and mortality rates, response to treatment, etc., will be evaluated.