Aims: Determining the origin of metastases is an important task of
pathologists to allow for the initiation of a tumor-specific therapy.
Recently, homeobox protein Hox-B13 (HOXB13) has been suggested as a new marker
for the detection of prostatic origin. The aim of this study was to evaluate
the diagnostic sensitivity of HOXB13 in comparison to commonly used
immunohistochemical markers for prostate cancer. Materials and methods:
Histologically confirmed prostate cancer lymph node metastases from 64 cases
were used to test the diagnostic value of immunohistochemical markers:
prostate specific antigen (PSA), Prostatic acid phosphatase (PSAP), prostate
specific membrane antigen (PSMA), homeobox gene NKX3.1, prostein, androgen
receptor (AR), HOXB13, and ETS-related gene (ERG). All markers were evaluated
semi-quantitatively using Remmele's immune reactive score. Results: The
detection rate of prostate origin of metastasis for single markers was 100%
for NKX3.1, 98.1% for AR, 84.3% for PSMA, 80.8% for PSA, 66% for PSAP, 60.4%
for HOXB13, 59.6% for prostein, and 50.0% for ERG. Conclusions: Our data
suggest that HOXB13 on its own lacks sensitivity for the detection of
prostatic origin. Therefore, this marker should be only used in conjunction
with other markers, preferably the highly specific PSA. The combination of PSA
with NKX3.1 shows a higher sensitivity and thus appears preferable in this
setting. View Full-Tex