Immunohistochemistry analysis of estrogen receptor and androgen receptor in benign prostatic hyperplasia and prostate carcinoma

Abstract

Benign prostatic hyperplasia (BPH) and prostate adenocarcinoma are the most common disorders affecting elderly men. The diseases are androgen-dependent and are treated by obstructing androgen receptor (AR) or their action. AR has direct relationship between the development of prostatic hyperplasia and prostatic carcinoma. Estrogens directly target prostate tissue by definite estrogen receptors (ER). The human prostate is primed with a dual system of ERs (ER-α and ER-β). Use of estrogens as hormonal agents is for suppressing prostatic tissue growth. Study aims to identify, assess and establish the significance of ER and AR as a marker in distinguishing BPH and prostatic carcinoma. A cross sectional study was conducted at a tertiary care hospital over a period of two year on 65 specimens which included 30 malignant cases and 35 benign cases. Specimens received were tru-cut biopsy, transurethral resection of prostate chips (TURP) and prostatectomy specimen for malignant cases and TURP for benign lesions. Paraffin embedded blocks was stained with H&E and IHC with ER and AR performed on representative sections and graded .the results were assessed for association with various parameters in both benign and malignant cases. Out of 30 cases of adenocarcinoma of prostate majority of specimens were needle biopsies (54%). The age of presentation was 55-84 years with mean age being 68.93 years. In cases of BPH the presenting age was 35-84 years and mean age was 63 years. Histopathological parameters assessed for malignant lesions, showed negative correlation of grade group with PNI and positive correlation with neutrophils. Higher grade showed adverse histological parameters. %PSA was <25% in malignancy. ER positivity was noted in 80% malignant and 100% benign cases with weaker positivity noted maximum in benign cases. AR positivity was noted in all cases both benign and malignant, with benign cases showing higher intensity. Hormones play a multifactorial role in the pathogenesis of BPH and prostatic carcinoma; most commonly androgen and estrogen, and can be used towards finding a better therapy.