Role of Triple Antibody Cocktail, α-methyl acyl-CoA Racemase (AMACR/P504S), high-molecular-weight cytokeratin (HMWCK 34βE12), and Transformation-related protein 63 TP-63 or P63) in Distinguishing Suspicious Prostatic Lesions

A BSTRACT Background: One of the most prevalent cancers in males worldwide is prostate cancer. Numerous benign conditions, including adenosis, atrophy, partial atrophy, basal cell hyperplasia, clear cell hyperplasia, and others, can mimic prostate cancer. In these situations, an underdiagnosis will have an impact on the prognosis, while an overdiagnosis may result in men without prostate cancer receiving needless therapy and causing incontinence or impotence. Among the many biomarkers examined, the triple marker—p63, high-molecular-weight cytokeratin (HMWCK), and α-methyl acyl-CoA racemase (AMACR)—has drawn a great deal of interest due to its possible use in diagnosing prostate neoplasms. Aim: The study was performed to ascertain the utility of AMACR, HMWCK, and p63 in suspicious prostatic lesions. Methods: A total of 100 cases received were classified into two main categories as benign and suspicious of malignancy based on hematoxylin and eosin staining evaluation. All the 25 suspicious cases were subjected to immunohistochemical analysis applying AMACR, HMWCK, and P63 to further confirm the diagnosis in these cases and classify as benign, premalignant, and malignant. Results: Out of 25 suspicious for prostatic malignancy cases, five cases were positive for AMACR and negative for HMWCK and P63 and hence were confirmed as malignant. Conclusion: It is very necessary to do all three markers (AMACR, HMWCK, P63) in the cases of prostate mimickers to reach the final accurate diagnosis.