Regarding diagnostic of ASAP, Shaw comments, "The CK5 and ERG multiplex IHC cocktail also increases confidence in diagnosis of ASAP or ATYP, since ERG positive samples are almost certain to be cancer."
Multiplex IHC can increase the clinical value that ERG delivers, enabling more accurate diagnosis of HGPIN and ASAP (ATYP) and potentially impacting aggressiveness of treatment, while increasing laboratory productivity.
The final biopsy diagnoses of ATYP and PINATYP were evaluated by IHC in 98% (51 of 52) of cases; in only one ATYP case, the focus was cut out on the initial levels and no IHC was ordered.
Intradepartmental consultation in conjunction with IHC was used more often in diagnostically challenging cases, resulting in final biopsy diagnosis of ATYP or PINATYP, whereas intradepartmental consultation was less frequent when the final diagnosis was Benign or High-Grade PIN.
This study also confirmed that IHC was mostly used in evaluating cases signed out as Cancer or ATYP (ATYP + PINATYP), which together represented 65.4% of the individual blocks assessed by IHC.
Final diagnoses of Cancer or ATYP (ATYP + PINATYP) were rendered in the majority of individual blocks assessed by IHC.