Prognostic Significance of High Androgen Receptor Expression in Prostatic Acinar Adenocarcinoma

Abstract

Background: Quantitative immunohistochemical expression of Androgen receptor (AR) has not been evaluated<br />as a prognostic biomarker of prostate cancer in our population, therefore in the current study we aimed to evaluate<br />the association of AR expression in prostatic acinar adenocarcinoma with various prognostic parameters like tumor<br />quantification, Gleason score, WHO grade group and perineural invasion. Methods: Total 121 cases of biopsy proven<br />prostatic acinar adenocarcinoma were selected from records of pathology department archives from January 2013 till<br />December 2017. Hematoxylin and eosin stained slides and paraffin blocks were retrieved and new sections were cut<br />where necessary. Slides of all cases were reviewed by two senior histopathologists and pathologic characteristics like<br />Gleason score, WHO grade, tumor quantification, perineural and lymphovascular invasion were evaluated. Androgen<br />receptor immunohistochemistry was applied on all cases. Results: Low AR expression was noted in 53 cases (43.8%)<br />while high AR expression was seen in 68 cases (56.2%). Significant association of AR expression was noted with total<br />Gleason score, WHO grade and percentage of tissue involvement (tumor quantification). Univariate binary logistic<br />regression showed patients with low Gleason scores (scores 6,7 or 8) and low WHO grade (grade 1, 2 or 3) were less<br />likely to express high AR expression in comparison to high Gleason score (score 9) and high WHO grade group<br />(grade 5) respectively. Similarly, cases with low tissue involvement by carcinoma (<50%) were less likely to show<br />high AR expression in comparison to cases with >50% tissue involvement by carcinoma. Conclusion: Significant<br />association of AR expression was noted with total Gleason score, WHO grade and percentage of tissue involvement<br />(tumor quantification) which are among the most important markers of tumor progression; therefore we suggest that AR<br />expression should be performed in patients with prostatic adenocarcinoma for prognostic stratification of the patients.