Diagnostic Value of ERG in Prostate Needle Biopsies Containing Minute Cancer Foci

Svitlana Y. Bachurska 1 , 2 , Dmitriy G. Staykov 1 , 2 , Ivan V. Bakardzhiev 3 , 4 , Petar A. Antonov 3 , 4  and Veselin T. Belovezhdov 1 , 2
  • 1 Department of General and Clinical Pathology and Forensic Medicine, Medical University of Plovdiv, 15A Vasil Aprilov Blvd., 4002 Plovdiv, Bulgaria Bulgaria
  • 2 Department of General and Clinical Pathology, St George University Hospital, Plovdiv, Bulgaria
  • 3 Department of Urology, Medical University of Plovdiv, Plovdiv, Bulgaria Bulgaria
  • 4 Clinic of Urology, St George University Hospital, Plovdiv, Bulgaria

Abstract

Background: Prostate carcinoma (PC) is the second most diagnosed cancer in men population worldwide. The small amount of the tissue in prostate needle biopsy is often sufficient for the correct interpretation. Novel antibodies, as ERG, could add to the diagnostic value of IHC study in analysing difficult core biopsies.

Aim: The aim of the present study was to establish a diagnostic use of ERG in a work-up of prostate needle biopsies containing minute PC, individually and in combination with AMACR/34βE12.

Materials and methods: From total number of 1710 consecutive prostate needle biopsies based on HE stain 114 biopsies containing minute PC. Selected biopsies were incubated with anti-ERG, AMACR and 34βE12 antibodies using immunohistochemical technique.

Results: Among 98 selected biopsies, 57 showed positive and 41 negative ERG staining. AMACR staining was positively expressed in 86 of the cases and completely absent in remaining 12. In 9 of the AMACR-negative cases the final diagnosis was establish by manifestation of ERG expression in the tumour foci. 95 of the biopsies demonstrated lack of 34βE12 expression and only 3 cases showed weak patchy staining. Among these cases 2 were ERG-positive.

Conclusion: ERG antibody could be especially helpful in the cases with controversial expression of AMACR and 34βE12.

If the inline PDF is not rendering correctly, you can download the PDF file here.

  • 1. Ferlay J, Shin HR, Bray E, et al. GLOBOCAN 2008, Cancer incidence and mortality worldwide: IARC CancerBase No. 10. Lyon, France: International Agency for Research on Cancer; 2010.

  • 2. Herawi M, Parwani AV, Irie J, et al. Small glandular proliferations on needle biopsies: most common benign mimickers of prostatic adenocarcinoma sent for expert second opinion. Am J Surg Pathol 2005;29:874-80.

  • 3. Tomlins SA, Rhodes DR, Perner S, et al. Recurrent fusion of TMPRSS2 and ETS transcription factor genes in prostate cancer. Science 2005;310:644-8.

  • 4. Mackinnon AC, Yan BC, Joseph LJ, et al. Molecular biology underlying the clinical heterogeneity of prostate cancer: an update. Arch Pathol Lab Med 2009;133:1033-40.

  • 5. Mosquera JM, Mehra R, Regan MM, et al. Prevalence of TMPRSS2:ERG fusion prostate cancer among men undergoing prostate biopsy in the United States. Clin Cancer Res 2009;15:4706-11.

  • 6. Tomlins SA, Bjartell A, Chinnaiyan AM, et al. ETS gene fusions in prostate cancer: from discovery to daily clinical practice. Eur Urol 2009;56:275-86.

  • 7. Yaskiv O, Rubin BP, He H, et al. ERG protein expression in human tumors detected with a rabbit monoclonal antibody. Am J Clin Pathol 2012;138:803-10.

  • 8. Park K, Tomlins SA, Mudaliar KM, et al. Antibodybased detection of ERG rearrangement - positive prostate cancer. Neoplasia 2010;12(7):590-8.

  • 9. Furusato B, Tan SH, Young D, et al. ERG oncoprotein expression in prostate cancer: clonal progression of ERG-positive tumor cells and potential for ERG-based stratifi cation. Prostate Cancer Prostatic Dis 2010;13(3):228-37.

  • 10. Allan RW, Sanderson H, Epstein JI. Correlation of minute (0.5 mm or less) focus of prostate adenocarcinoma on needle biopsy with radical prostatectomy specimen: role of prostate specifi c antigen density. J Urol 2003;170:370-2.

  • 11. Shah RB, Tadros Y, Brummell B, et al. The diagnostic use of ERG in resolving an “atypical glands suspicious for cancer” diagnosis in prostate biopsies beyond that provided by basal cell and α-methylacyl-CoA-racemase markers. Hum Pathol 2013;44:786-94.

  • 12. Väänänen RM, Lilja H, Kauko L, et al. Cancer-associated changes in the expression of TMPRSS2-ERG, PCA3, and SPINK1 in histologically benign tissue from cancerous vs noncancerous prostatectomy specimens. Urol 2014;83(2):511.e1-7.

  • 13. Wang JJ, Liy YX, Wang W, et al. Fusion between TMPRSS2 and ETS family members (ERG, ETV1, ETV4) in prostate cancers from Northern China. Asian Pacifi c J Cancer Prev 2013;10:4935-8.

  • 14. Kaczmarczyk K, Dyduch G, Białas M, et al. Frequency of ERG-positive prostate carcinoma in Polands. Pol J Pathol 2013;64(3):175-9.

  • 15. van Leenders GJ, Boormans JL, Vissers CJ, et al. Antibody EPR3864 is specifi c for ERG genomic fusions in prostate cancer: implications for pathological practice. Mod Pathol 2011;24(8):1128-38.

  • 16. Mosquera JM, Perner S, Genega EM, et al. Characterization of TMPRSS2-ERG fusion high-grade prostatic intraepithelial neoplasia and potential clinical implications. Clin Cancer Res 2008;14(11): 3380-5.

OPEN ACCESS

Journal + Issues

Search