Quadruple Immunohistochemistry Stain Improves Cancer Detection

Bostwick Laboratories offers the QuadVysion™ immunohistochemistry stain to improve the detection sensitivity for prostate cancer on difficult prostate needle biopsies. The immunohistochemistry stain consists of four antibodies: racemase (P504S), high molecular weight cytokeratin (34ß-E12), p63 and c-myc.

Alpha-methylacyl-CoA-racemase (racemase)
Also referred to as P504S protein. Moderate to strong staining of this protein is seen in prostate cancer and high-grade PIN, but not in benign prostatic tissue.

c-myc protein
Moderate to strong nuclear staining of this protein is seen in prostate cancer and high-grade PIN, but usually not in benign prostatic tissue.

High molecular weight cytokeratin antibody (34ß-E12)
Stains the cytoplasm of basal cells of the prostate. Increasing grades of PIN are associated with progressive disruption of the basal cell layer. Cancer cells consistently fail to react with this antibody.

p63 antibody stains the nucleus of basal cells
Basal cell cocktail (34ß-E12 and p63) increases the sensitivity of the basal cell detection and reduces staining variability thus rendering basal cell immunostaining more consistent.

Bostwick Laboratories uses the QuadVysion immunohistochemistry stain routinely in practice and finds it to be very useful for the diagnosis of small foci of prostate cancers. Negative immunohistochemistry staining for basal cells is not diagnostic of carcinoma by itself as occasional benign glands may not show immunoreactivity. Therefore, a positive cytoplasmic staining of racemase is of great value in confirming malignancy.