Role of androgen receptor in prostatic neoplasia versus hyperplasia

Introduction: Androgens play a fundamental role in the growth, differentiation, and maintenance of prostate tissue. The objective of the study was to evaluate and compare the androgen receptor (AR) expression in benign prostatic hyperplasia (BPH), prostatic intraepithelial neoplasia (PIN), and prostatic adenocarcinoma. A relationship between the Gleason score and AR expression was also determined in cases of prostatic adenocarcinoma. Materials and Methods: A total of 25 cases were collected which included 10 cases of prostatic adenocarcinoma, 10 cases of BPH, and five cases of PIN. Histopathological evaluation was done to determine the type of lesion including Gleason scoring. Immunohistochemistry (IHC) was performed for AR using monoclonal anti-AR antibody. Results: Specific AR immunostaining was present in all 25 cases in varying intensity. The staining was more intense in cases of adenocarcinoma and PIN as compared BPH. There was no significant statistical difference in the intensity of staining of AR. The Gleason score was inversely related to the intensity of AR staining in adenocarcinoma. There was no significant statistical association between the AR expression and tumor, necrosis, metastasis (TNM) stage. Discussion: AR nuclear expression is present in benign and malignant prostatic epithelium. In this study, cases of prostate cancer demonstrated a higher staining intensity for AR when compared with BPH. The intensity of AR staining in prostate cancer significantly reduces as the Gleason grade of the tumor increases. The staining intensity for AR was heterogeneous specifically in cases of prostate cancer. Our results indicate that AR maybe considered as a prognostic marker in prostate cancer.