The utility of basal cell-specific anti-cytokeratin antibody (34 beta E12) in the diagnosis of XXXX . A review of 228 cases.

@entity1 @entity263 @entity5 @entity1711 @entity1491 @entity3923 @entity1710 @entity194 @entity5436
Basal cell-specific anti-cytokeratin antibody (34 beta E12) decorates the basal cells of benign prostatic epithelium by standard immunohistochemical techniques, whereas @entity263 lacks immunoreactivity with this antibody. We reviewed our experience with this antibody to determine its utility in the diagnosis of @entity263 as well as its pattern of usage at a tertiary medical center. In all, 7,242 prostate specimens from 5,262 @entity1 were seen at Johns Hopkins Hospital between 1/89 and 4/93. Immunostaining for basal cell-specific cytokeratin (34 beta E12) was originally used for diagnostic purposes in 289 questionable area from 228 cases; 45% of these cases were seen in consultation. The distribution of cases using 34 beta E12 was 52% needle biopsies, 32% transurethral prostatic resections (TURPs). 13% radical prostatectomies, and 3% open enucleations. These procedures constituted 2.8% of all needle biopsies, 7.2% of all TURPs, 1.7% of all radical prostatectomies, and 3.5% of all enucleations seen during this time period. For this study the @entity1710 and @entity1711 stain was reviewed without knowledge of the original diagnosis, a diagnosis was favored, the 34 beta E12 stain was examined, and a final diagnosis was determined. The 34 beta E12 stain established (14%), confirmed (58%), or changed (2%) our favored diagnoses, while 18% remained or became equivocal. The 34 beta E12 stain was of no use in 8% of the cases, yet we felt we were still able to render a final diagnosis even without the help of the stain. The differential diagnoses in the questionable foci using 34 beta E12 were @entity5 versus focus of atypical glands (44%), @entity3923 (39%), @entity5436 ( @entity5436 ) (8%), @entity1491 (5%), and @entity194 (4%). However, 34 beta E12 was used in only 15-20% of all cases of @entity3923 and @entity1491 and in < 2% of @entity5436 and @entity194 cases seen during this time. Reasons for equivocal results were loss of suspicious glands on cut downs used for staining (49%), too few glands to rely on negative staining (23%), technical problems (15%), limited number of positive staining glands in a small focus (7%), and cautery artifact (6%). Although equivocal cases tended to have fewer negative stained glands than cases diagnosed with @entity5 , there was no minimum number of negative stained glands required to establish a diagnosis of @entity5 . From these data we conclude that 34 beta E12 staining is a useful tool in confirming, establishing, or changing the diagnosis in questionable foci seen in the everyday practice of surgical pathology.(ABSTRACT TRUNCATED AT 400 WORDS)
