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Comparison of annexin II, p63 and α-methylacyl-CoA racemase immunoreactivity in prostatic tissue: a tissue microarray study
  1. Jocelyn Stewart1,
  2. Neil Fleshner2,
  3. Heather Cole1,
  4. Joan Sweet1
  1. 1Department of Pathology, University Health Network, Toronto General Hospital, Toronto, Ontario, Canada
  2. 2Department of Surgery, Division of Urology, Princess Margaret Hospital and University of Toronto, Toronto, Ontario, Canada
  1. Correspondence to:
 Dr Joan Sweet
 E11-037 200 Elizabeth Street, Toronto, Ontario, Canada, M5G 2C4; joan.sweet{at}


Background: Current ancillary markers for diagnosis in prostate biopsies include p63 and α-methylacyl-CoA racemase (AMACR). Annexin II (ANXII), a calcium and phospholipid binding protein, is lost in prostate cancer.

Aims: To investigate ANXII expression in order to assess its utility as a novel diagnostic marker in comparison to p63 and AMACR.

Methods: Using immunohistochemistry on six tissue microarrays, ANXII, p63, and AMACR expression was analysed from 210 radical prostatectomy cases. Staining was evaluated in benign and atrophic glands, high-grade prostatic intraepithelial neoplasia (HGPIN), and prostatic adenocarcinoma. Separate scores were given for ANXII, AMACR and p63 expression.

Results: Diffuse cytoplasmic expression of ANXII correlated with p63 reactivity in basal cells. Benign glands were positive for ANXII in 286/292 cores (98%) and negative for AMACR in all 292 cores. HGPIN showed heterogeneous expression of AMACR and ANXII. A significantly larger proportion of HGPIN glands were correctly identified as ANXII negative than as positive for AMACR. ANXII loss in prostate cancer was found in 282/320 cores (88%) and correlated with positive AMACR expression (272/320 cores, 85%), which was not statistically significant. There was no statistically significant correlation between ANXII scores and the clinical parameters examined.

Conclusions: Immunohistochemical staining for ANXII is a consistent and reliable marker of prostatic neoplasia. The findings of this study suggest the potential utility of ANXII as a diagnostic aid in prostate cancer histopathology.

  • AMACR, α-methylacyl-CoA racemase
  • ANXII, annexin II
  • HGPIN, high-grade prostatic intraepithelial neoplasia
  • annexin A2
  • α-methylacyl-CoA racemase
  • diagnostic markers
  • prostatic intraepithelial neoplasia
  • prostatic neoplasms

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  • Published Online First 17 August 2006

  • Funding for this project was provided by the Prostate Clinical Research Program at the Princess Margaret Hospital. Study sponsors had no involvement in the study design; the collection, analysis, or interpretation of data; the composition of the report; or the decision to submit the paper for publication.

  • Competing interests: None.