الفهرس 
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Abstract
Prostate cancer is the second most common diagnosed cancer and the fifth leading cause of cancer related death among men. Identification of cancer origin, especially in cases of dedifferentiation, is critical for proper patient management and treatment. Hence, discovering novel biomarkers and studying their expression is essential.
Prostein is a 553-amino acid protein that shows perinuclear granular cytoplasmic staining. It is encoded by the SLC4A3 gene. It’s located on chromosome 1 at the WI-9641 locus. Prostein biomarker identifies both benign and malignant prostatic neoplasm. Most of the studies concluded that prostein is a highly specific and highly sensitive marker. Only one study found an extra-prostatic expression of prostein in Leydig cells of Sertoli-Leydig cell tumor and Rete testis adenocarcinoma.
Prostatic specific antigen is a serine protease enzyme produced by the epithelial cells of the prostate. It is encoded by kallikrein related peptidase 3 located on chromosome 19. PSA immunostaining is a widely used marker to identify prostatic tissue of unknown primary. The marker has been widely studied and was found to be expressed in other non-prostatic tissue including testicular tumors. Studies also revealed the inverse relation between prostatic adenocarcinoma tumor grade and PSA expression.
The aim of this work is to study the immunohistochemical expression of Prostein (P501S) in different grades of prostatic adenocarcinoma and compare it to prostatic specific antigen.
Prostein and PSA were studied in 45 cases of PCa divided into 15 cases of well differentiated adenocarcinoma, 15 cases of moderately differentiated adenocarcinoma and 15 cases of poorly differentiated adenocarcinoma.
Immune staining reaction in both markers was calculated and categorized into 4 groups (No staining, markedly reduced staining, weak staining, and strong staining).
Both prostein and PSA showed strong immune staining reaction scores in the well differentiated prostatic adenocarcinoma with no differences.
In the moderately differentiated adenocarcinoma, no statistical difference was observed between the 2 immune markers (p >0.05). However, microscopically, one could appreciate a difference especially in the intensity of staining reaction.
In the poorly differentiated adenocarcinoma. A statistical difference has been observed between the two groups. Prostein showed higher immune staining reaction score in almost all studied cases compared to PSA. PSA showed no staining reaction in some of the studied cases, also PSA did not show any strong immune staining reaction in the poorly differentiated neoplasms.