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Diagnostic Utility of Proliferative Cell Markers in Prostatic Lesions: An Institutional Experience

Background: Prostatic cancer is a complex and biologically heterogenous disease. Diagnosis of prostatic lesions with immunohistochemistry still faces challenges because of difference in reactivity of monoclonal antibodies in benign, equivocal, and malignant lesions. Proliferative markers Ki-67 and Proliferating Cell Nuclear Antigen (PCNA) can be used for diagnosis and prognostic stratification of prostatic carcinoma. 
Methods: A total of hundred prostate biopsies with 50 cases each of benign prostatic hyperplasia and prostate carcinoma received in the Department of Pathology, PGIMS, Rohtak, India were included in the study. Ki-67 and PCNA expression was studied immunohistochemically in each case. 
Result: Ki-67 expression was significantly upregulated in malignant cases and increased with increasing Gleason grade. PCNA expression was also found to be increased in increasing Gleason grades in carcinoma cases, however, the results were ambiguous as it was found to be positive in all benign cases also. 
Conclusion: Ki-67 is useful in predicting biological behavior in prostate carcinoma cases, however PCNA expression needs to be studied further.