Tall_Allen recently mentioned a prostate cancer diagnostic tool called an IHC : "The IHC should include as many of these as possible: AR (androgen receptor), PSA, PSMA, MSH2, MSH6, STEAP1, PD-L1, chromogranin A (CGA), neuron-specific enolase (NSE), synaptophysin (SYP), DLL-3, CD56, Somatostatin (SST).In your case, an FDG PET scan may show more than a PSMA PET." Tall_Allen
Has anyone ever had this?
Do you know what it is good for? What it is not good for? When to use it? When it is not useful.
What it does that other diagnostic tools don't?
Thanks
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cesanon
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It is genetic testing. I had it don on my tumor it picked up TMPRSS2/ERG fusion and MSH6-Loss before sample got degraded. It was from my 5yr old prostatectomy so it was near end of life for genetic testing.
Immunohistochemistry (IHC) is an important application of monoclonal as well as polyclonal antibodies to determine the tissue distribution of an antigen of interest in health and disease. IHC is widely used for diagnosis of cancers; specific tumor antigens are expressed de novo or up-regulated in certain cancers. This article deals with the various applications of IHC in diagnosis of diseases, with IHC playing an important role in diagnostic and research laboratories.
This is nothing new. If you are really interested on how Pathologists aid a Medical Oncologist, please read:
Interesting thanks.So even though it is used a a marker for PCa progression no medical practice can be used because these markers Ki-67, p53, ERG (i have), PTEN, and MYC have not been validated.
Here is the conclusion of the above linked 2018 study.
The only thing in my favor is the darolutamide i am taking interferes with the TMPRSS2/ERG fusion. Which by the way is the exact same pathway covid uses to enter cells.
Conclusion
In summary, there are several studies relating immunohistochemical markers with clinical-laboratory outcomes in prostate cancer, the most frequent being Ki-67, p53, ERG, PTEN, and MYC. However, none of these markers have been validated and, consequently, they cannot be applied in medical practice.
Positive staining for Ki-67, p53 and MYC were related to higher tumor grade and stage. Ki-67 was also related to PSA levels, disease-free interval and tumor-specific survival (the latter also being related to p53). For PTEN, its loss showed a higher association with biochemical recurrence and a worse prognosis, as well as Gleason score and tumor stage. Finally, ERG showed a strong association with biochemical recurrence.
If applied in specific situations, the use of these markers could guide the process of therapeutic decision making.
I have TMPRSS2/ERG fusion and MSH6-Loss and as far as my Oncologist knows that 50% of advanced PCa have this IHC marker in tumors but their is no specific trials or drugs that are made to target this.
Big thing here is thelutamides like darolutamide, Enzalutimide and apalutamide actually block this genes sction preventing cell permeability.
The other really HUGE thing is thanks to Covid 19 is that this same gene TMPRSS2 is used by the spike protein to enter cells and the research into this has exploded with unlimited funding and fast tracked research it. COVID also uses Testosterone so PCa and Covid are so intertwined that we are learning about PCa fast and furious.
Unfortunately I haven’t studied p53 gene but it is one of the most important anti cancer fighting gene.
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Is it Prostate Metastases or Lung cancer
Stage 4 A Prostate cancer
Treatment options for metastatic prostate cancer? 
Any Curative Treatments after RT as Sole Primary Treatment?
Diagnosed with metastatic prostate cancer 2016.
