Polyclonal anti-PSA is more sensitive but less specific than monoclonal anti-PSA: Implications for diagnostic prostatic pathology

Murali Varma, Meleri Morgan, Bharat Jasani, Pheroze Tamboli, Mahul B. Amin

Research output: Contribution to journalArticlepeer-review

45 Citations (Scopus)

Abstract

Prostate-specific antigen (PSA) production by nonprostatic tissues has been reported, casting doubts on its specificity. The immunohistochemical relative specificity and sensitivity of PSA expression using monoclonal and polyclonal anti-PSA was analyzed on 60 prostate carcinomas, 40 normal seminal vesicles, and 310 nonprostatic tumors. All nonprostatic tumors proved negative with both antibodies. However, 13 (32%) seminal vesicles showed immunoreactivity with polyclonal anti-PSA, but none showed immunoreactivity with the monoclonal antibody. The sensitivity of the 2 antibodies for prostate cancer varied with tumor grade. In Gleason pattern 3, both antibodies showed diffuse immunostaining in all cases. In Gleason pattern 5, polyclonal anti-PSA showed diffuse (>95%) tumor cell positivity in 18 cases (90%), while with the monoclonal antibody, 7 cases (35%) showed only focal (<10%) tumor cell immunoreactivity. Thus, monoclonal anti-PSA seems to be useful in small gland proliferations in which the differential diagnosis includes seminal vesicle, while for poorly differentiated neoplasms, polyclonal anti-PSA is considered superior. Sections of high-grade prostate cancer should be included as positive controls for PSA immunostaining.

Original languageEnglish
Pages (from-to)202-207
Number of pages6
JournalAmerican Journal of Clinical Pathology
Volume118
Issue number2
DOIs
Publication statusPublished - Aug 1 2002

Keywords

  • Immunohistochemistry
  • Prostate
  • Prostate-specific antigen
  • Seminal vesicles
  • Sensitivity
  • Specificity

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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