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. 2019 Sep 9;152(4):495-501.
doi: 10.1093/ajcp/aqz063.

Utility of NKX3.1 Immunostaining in the Detection of Metastatic Prostatic Carcinoma on Fine-Needle Aspiration Smears

Qiong Gan  1 , Cicily T Joseph  1 , Ming Guo  1 , Miao Zhang  1 , Xiaoping Sun  1 , Yun Gong  1
Affiliations

Utility of NKX3.1 Immunostaining in the Detection of Metastatic Prostatic Carcinoma on Fine-Needle Aspiration Smears

Qiong Gan et al. Am J Clin Pathol. .

Abstract

Objectives: NK3 homeobox 1 (NKX3.1) has been increasingly used to diagnose metastatic prostatic carcinoma in histologic samples. However, its utility and reliability in cytologic direct smears have not been studied.

Methods: A total of 59 fine-needle aspiration (FNA) cases with a definitive diagnosis of metastatic carcinoma from the prostate were included. The cases were grouped based on different Gleason score in their corresponding primary tumors and morphologic variants. For each case, tumor cells were immunostained with NKX3.1, prostate-specific antigen (PSA), and prostatic acid phosphatase (PAP) on cell-transferred smears.

Results: NKX3.1 was strongly and diffusely positive in all 40 metastatic prostatic adenocarcinomas, including those with ductal features, but negative for the 19 small cell carcinoma (SmCC) cases. NKX3.1 had a better detection rate than PSA (13/50, 26%) and PAP (0/47, 0%).

Conclusions: NKX3.1 immunostaining on FNA smears is highly reliable for detecting metastatic prostatic carcinomas of conventional and ductal types but not for SmCC.

Keywords: Fine-needle aspiration; Metastatic prostatic carcinoma; NKX3.1; Smeared slide.

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Figures

Image 1
Image 1
Representative pictures of Papanicolaou-stained smears and NK3 homeobox 1 (NKX3.1) immunostaining for study groups 1, 4, 5, and 6. Papanicolaou-stained smears, ×100; NKX3.1 immunoperoxidase stains, ×100; NKX3.1 immunoperoxidase stains, ×400. GS, Gleason score; SmCC, small cell carcinoma.
See this image and copyright information in PMC

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