Clinicopathological features of metastatic castration-resistant prostate cancer

Abstract

Objective To investigate the histopathological characteristics of metastatic castration-resistant prostate cancer. Methods Clinical findings, morphologic features, immunophenotypes of androgen receptor(AR), prostatic specific antigen(PSA), chromogranin A(CgA), and phosphatase and tensin homolog deleted on chromosome ten(PTEN)(by EnVision method)of 178 core biopsies from patients with metastatic castration-resistant prostate cancer encountered from January 2010 to January 2015 from West Coast Dream Team were analyzed. Results In the 178 cases, 51(28.7%)were diagnosed with typical adenocarcinoma, 41 cases(23.0%)with intermediate atypical carcinoma and 24 cases(13.5%)with small cell carcinoma.The expression of PSA was significantly lower in patients with intermediate atypical carcinoma or with small cell carcinoma(31/39, 79.5%)than in those with adenocarcinoma(20/20, 100%). The expression of PTEN was significantly higher in patient with intermediate atypical carcinoma or with small cell carcinoma(31/46, 67.4%)than in those with adenocarcinoma(19/41, 46.3%). Conclusions Three histopathological subtypes exists in metastatic castration-resistant prostate cancer, including adenocarcinoma, intermediate type atypical carcinoma and small cell carcinoma.They are entities with unique pathological features.The expression of PTEN is significantly lower in the patients with intermediate atypical carcinoma or with small cell carcinoma than in those with adenocarcinoma, indicating that intermediate atypical carcinoma and small cell carcinoma are different from typical adenocarcinoma in tumor occurrence and progression. Key words: Prostatic neoplasms; Neoplasm metastasis; Testosterone