Clinicopathological correlation of p53 expression in benign prostatic hyperplasia and prostate adenocarcinoma

Abstract

Prostate adenocarcinoma is the 6 most common carcinoma in men worldwide. It is usually a cancer of the elderly age group. Benign prostatic hyperplasia is a common cause of urinary incontinence and urine flow symptoms, usually seen in the middle along with elderly age group. In this study we have evaluated the expression of p53 immunohistochemistry (IHC) in prostate adenocarcinoma with benign prostatic hyperplasia along with its diagnostic, treatment and prognostic implications.: 1. Assessment of clinical and biochemical parameters in patients with benign prostatic hyperplasia (BPH) and prostate adenocarcinoma. 2. To assess p53(IHC) expression in benign prostatic hyperplasia and prostate adenocarcinoma : The study population comprised of a subset of patients who came to Ramaiah hospital, Bangalore from May 2018 till June 2019, for treatment regarding prostate related symptoms. The clinicodemographic data was collected and prostate biopsies were taken for which histopathological assessment was done. A total of 60 cases comprising of 30 cases of BPH and 30 cases of prostatic adenocarcinoma was subjected to p53 immunohistochemistry. The results were tabulated and statistically analyzed for significance.The present prospective study was conducted on 60 patients with 30 cases (50%) of BPH and 30 cases (50%) of prostatic adenocarcinoma. Based on the tumor differentiation there was 1 case (3.3%) of well differentiated carcinoma, 18 cases(60%) of moderately differentiated carcinoma and 11cases (36.6%) of poorly differentiated carcinomas. We observed an inverse relationship between p53 expression and histological grade. All poorly differentiated carcinoma had higher p53(>50% expression). There was statistically significant difference in expression of p53 between cases of BPH and carcinoma prostate, indicated by P value of <0.05. Among prostate carcinomas p53 had higher expression on those cases with Gleason score 9 and 10.: P53 expression directly correlates with Gleason score, while inversely correlating with tumor differentiation of prostate carcinoma cases. The expression of p53 is low in BPH as compared to that of prostate cancers. Hence it can be used as a good diagnostic and prognostic marker in prostate carcinoma.