*Co esponding au ho : Babi a Sodhi
Copy igh © 2025 Au ho (s) e ain he copy igh o his a icle. This a icle is published unde he e ms o he C ea i e Commons A ibu ion License 4.0.
Immunohis ochemical analysis o P oges e one ecep o s in all P os a ic lesions, Case
se ies s udy o 40 cases and e iew o Li e a u e
Babi a Sodhi 1, * and Jyo sna Punj 2
1 Senio Consul an , Depa men o Pa hology, Max Supe Special y Hospi al, New Delhi, India.
2 P o esso , Depa men o Anes hesia, AIIMS, New Delhi, India.
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 27(01), 1609-1617
Publica ion his o y: Recei ed on 02 June 2025; e ised on 13 July 2025; accep ed on 16 July 2025
A icle DOI: h ps://doi.o g/10.30574/wja .2025.27.1.2661
Abs ac
Backg ound: In scena io o scan da a li e a u e, his s udy was conduc ed o p oges e one ecep o as u u e
ho mone he apy in p os a e lesions especially p os a e cance .
In oduc ion: P os a e cance as leading cause o mo ali y, p oges e one ecep o o be en isaged as u u e adjunc
ho mone he apy o educe mo bidi y and mo ali y o p os a e. Ca cinoma p os a e being he e ogenous disease, no
much is known abou biological beha iou o P oges e one ecep o s.
Ma e ial and me hods: 40 cases o p os a e, BHP, BHP wi h p os a i is, HGPIN and Adenoca cinoma we e included
whe e exp essions o P oges e one ecep o s was ca ied ou immunohis ochemically.
Conclusion: PR analysed as Good p ognos ic ma ke , can be au hen ica ed as u u e adjunc ho mone he apy, Mo e
S udies equi ed o au hen ica e i , Ou s udy has been adjunc o ha
Keywo ds: PR (p oges e one ecep o s); ER (Es ogen ecep o s); IHC (immunohis ochemis y); BHP (benign
hype plasia p os a e); ADC (Adenoca cinoma); HGPIN (High g ade p os a ic in aepi helial neoplasia)
1. In oduc ion
P os a e being la ges i al accesso y o gan o male ep oduc i e sys em, ana omically di ided on o an e io , middle,
pos e io and la e al lobes and Pe iphe al Zone (whe e mos ca cinomas a ise, hence asymp oma ic), cen al and
ansis ion zones (pe iu e h al) , whe e benign hype plasia p os a e occu s and symp oma ic) [1]. His ologically is a
ubuloal eola o gan, b anching duc -acina glandula sys em embedded in an e io ly placed ib omuscula s oma.
Mic oscopically epi helium is cen al luminal sec e o y and ou e basal cell laye . P os a e is p one o many pa hological
cond ions like ca cinoma , BHP, including in lamma o y en i ies, p os a i is and G anuloma ous p os a i is. Mo e han
1 lesion can be in combina ion wi h each o he , BHP (Benign hype plasia P os a e) wi h P os a i is. P os a e loca ed in
on o ec um, below and behind base o bladde wi h seminal esicles si ua ed supe io and pos e io o p os a e.
Role o P oges e one ecep o s in pa hophysiology and biology o he p os a e is in p og ess wi h ongoing added
li e a a u e om u u e s udies.
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 27(01), 1609-1617
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PR, P oges e one ecep o s one o s e oid ho mone ecep o amily including and ogen ecep o s (AR) and es ogen
ecep o s (ER), a e in anuclea in hei localiza ion, a e inc easingly ecognized o i s ole in p os a ic pa hological
and biological p ocesses.
P o ein occu s as 3 iso o ms, PRA, PRB, PRC and 11 splice a ian s. PRB being ull leng h ecep o , whe eas PRA is
unca ed one lacking in 164 amino acids a N e minus, which a e unique o PRB. These iso o ms pe o m di e en
physiological unc ions. PRA may e en inhibi PRB p oduc ion.
PR can unc ion by bo h genomic and non genomic modes o signalling and may de e mine ele ance and alidi y o PR
in p og ession, p ognosis and managemen o p os a e cance s.
PR ge exp essed in p os a e s oma and epi helium and hei exp ession can indica e i s ole in p os a e diseases. PR
localiza ion in heal hy p os a e and i s a ious lesions is well ca ied h ough widely accep ed s aining echnique o IHC.
IHC, a scien i ic labo a o y echnique, includes highly speci ic binding be ween an ibody and i s a ge an igen,
p o iding isual inspec ion o p o ein exp ession wi hin issue sec ions.
IHC is c ucial o assessmen o mul iple p edic i e and p ognos ic bioma ke s and i s ole in PR exp ession is i al as
PR in p os a e physiology and ca cinogenesis s ill o be unde s ood ully.
Cu en li e a u e wi h some con adic o y s udies ega ding i s p esence in umo cells, make IHC essen ial o o e
deepe insigh s in o disease p og ession and o iden i y PR as no el he apeu ic agen .
P os a e cance is second mos common cance in Men in Asia and 5 h leading cause o mo ali y wo ldwide, disease o
elde ly, a e age age being >65y s. Globally No h Ame ica has highes incidence (73.1%) [A ican Ame icans a highes
isk], ollowed by Eu ope (62.1%), A ica (36.6%), Asia (11.5%). Di e ence a ibu able o di e en sociological,
en i onmen al and gene ic ac o s.In Asia [2]. Japanese a e mo e p one o p os a e cance due o gene ic polymo phism
o PR Gene, bu h ough consump ion o Soy p oduc s, panee (To u) and soy milk, hey ha e b ough down incidence
o lowes , ISOFLAVONES IN SOY DIET HAS HELPED hem [3].
Aim o S udy o Immunohis ochemical analysis o PR in all p os a ic lesions is o documen PR as u u e a ge ed he apy
in P os a ic Ca cinoma.
Aims and Objec i es
To s udy immunohis ochemical Exp ession o P oges e one ecep o s,
• Thei ole and P ognos ic impac in di e en lesions o p os a e, especially BHP and Adenoca cinoma P os a e,
di e en ia e benign om malignan and in si u lesions(HGPIN).
• Di e en ia e p ima y Adenoca cinomas om me as a ic deposi s in p os a e.
• Co ela e exp essions o a ious g ades o di e en ypes o p os a ic ca cinoma.
• Co ela e exp essi i y wi h me as a ic disease and hus e alua e p ognos ic signi icance.
2. Ma e ial and me hods
S udy was Conduc ed in 40 cases o p os a e biopsy (TURP) in e ia y ca e hospi al, ou o which 33 cases o BHP(24
o pu e BHP, 8 o BHP wi h p os a i is and 1 case o BHP wi h ex ensi e squamous me aplasia), 4 Cases o HGPIN, 3
cases o Adenoca cinoma in which 2 cases being ankly malignan and 1 case ocally malignan . 10 posi i e con ols o
p oli e a i e phase Endome ium (u e us) wi h no e idence o any u e ine lesion we e also pu .
3. Resul s
Mos common p esen a ion in BHP was equency o u ina ion in 80% and noc u ia, dysu ia, e en ion u ine wi h
d ibbling in es o cases.
1 case o adenoca cinoma p esen ed wi h bony pains, while o he 2 cases and 4 cases o HGPIN we e asymp oma ic
excep ha wi h anaemia, gene al unwell being and emacia ion. No case p esen ed wi h blood in u ine.
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 27(01), 1609-1617
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BHP, disease o p os a e in 5 h o 8 h decade wi h no case less han 40, 2 cases each in 5 h o 6 h decade, 17 cases in 7 h
decade and 1 case in 8 h decade.
Figu e 1 Age wise Dis ibu ion o BHP (pe cen age)
HGPIN, disease o p os a e in 6 h – 8 h decade, 1 case each in 6 h and 7 h decade and 2 cases in 8 h decade and no case in
9 h decade.
Figu e 2 Age wise Dis ibu ion o HGPIN (pe cen age)
Resul s:- Adenoca cinoma o p os a e in 7 h – 9 h decade, 1 case each in 7 h, 8 h and 9 h decade
Figu e 3 Age wise Dis ibu ion o Adenoca cinoma (Pe cen age)
3.1. Immunosco ing
Quick sco e me hod o assessmen was used o assess ange o immunos aining.
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 27(01), 1609-1617
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1 o 33 BHP Cases, was s ongly posi i e (b own colou ) 4+, bo h glandula epi helium and s oma (100%), 11 BHP
cases wi h %age posi i i y o 14- 21%, o al sco e(in ensi y + p opo ion sco e) o 3+, while es o 21 BHP cases wi h
%age posi i i y o 13-20% wi h o al sco e o 2+.
Only 1 o 4 HGPIN cases was mildly posi i e (18%), o al sco e o 1+, while es 3 cases o PIN we e ssion o o ally
nega i e.
All 3 Adenoca cinoma cases we e nega i e o exp ession (Ze o sco e)
Figu e 4 Con ol (Endome ium)
Figu e 5 BHP, PR Immunos aining
Figu e 6 HGPIN, PR Immunos aining
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 27(01), 1609-1617
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Figu e 7 Adenoca cinoma, PR Immunos aining
4. Discussion
P os a e cance accoun s o 25% o all male cance s, es icula 1%, penile cance s e en a e (4). Rema kable sha p
Inc ease in incidence o p os a e cance wi h age is hallma k o his cance . Incidence in I aqi popula ion is ising a pa
wi h global inc ease in incidence. [5], Quasi egan die in Japan ha ing p o ec i e unc ion in p os a e cance has played
signi ican ole in lowe ing i s incidence in japanese popula ion [6].
In ou s udy o analysis o 40 cases, PR exp ession is educed in Ca cinoma indica ing ha i p e en s umo igenesis,
hence p o ing i sel as a Good P ognos ic ma ke .
P oges e one epo ed o inhibi BHP and P os a e cance possibly due o i s e ec on SRD5A2 (gene ha encodes o
enzyme, s e iod 5 alpha educ ase 2 and LH (Leu inizing ho mone) elease.
Figu e 8 P oges e one e ec on s e oid 5 alpha educ ase 2 ( SRD5A2)
Pagi S e al documen ed exp ession o PR in BHP and Adenoca cinoma cases in simila way as ou s udy [7].
Focus is mo e on malignan and p emalignan lesions (Hgpin) [8].
PR a e nuclea amily o ecep o s, o 2 ypes, PRA and PRB exp essed in human issues including p os a e and in some
cance s [9,10].
Be a KN and Yada e al analysed immunoexp ession o ER Be a, PR in P os a ic Adenoca cinoma and esul s ma ched
wi h ou s udy [11].
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 27(01), 1609-1617
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O he o gans exp essing hem include b eas , b ain, kidney, Nasal ex anodal NK/T cell lymphoma and o a ian
ca cinomas [12-16].
PR shows i s exp essi i y no only in sex co ela ed cance s ( ep oduc i e), bu also in o he issues (Non ep oduc i e),
like human leukemia [17], hepa ocellula ca cinoma [18], panc ea ic neoplasms19], cen al ne ous sys em umo s
(Meningioma and ib oma) [20], u e ine Leiomyoma [21], Leiomyosa coma [22] and Ce ical in aepi helial neoplasia
(CIN III) [23] (Non ep oduc i e unc ions).
Role o p oges e one and P oges e one ecep o s was u he elabo a ed in human ep oduc ion and cance [24].
Te anu e al u he documen ed sys emic dis ibu ion o p oges e one ecep o s in human issues [25].
P oges e one in BHP can supp ess s omal cell p oli e a ion hus inhibi ing hype plasia and also di e en ial exp ession
o AR, ER and PR was s udied in benign hype plasia p os a e [26, 27,28].
G inds ad e al documen ed inc eased le els o PRB iso o m associa ed wi h disease p og ession which is con a y o
ou s udy, and ha can be possibly due o di e en ypes o isome s, di e en An igen e ie al as well [29].
Table 1 Compa a i e Immunohis ochemical Exp ession o P oges e one Recep o s in Benign P os a ic Hype plasia and
P os a ic Adenoca cinoma
Cha ac e is ic
Benign P os a ic
Hype plasia (BPH)
P os a ic Adenoca cinoma
(PCa)
Key Findings/Role
Rele an
Snippe
IDs
Cellula
Localiza ion
P ima ily s omal cells
( ib oblas s, smoo h
muscle cells).10 Nega i e
in lining epi helial cells.7
De ec ed in p ima y umo
cells (epi helial) 30 and umo
s omal cells.29 Con lic ing
epo s on epi helial
p esence.29
PR is p esen in s omal
compa men s o bo h,
bu i s p esence in
epi helial cells is mo e
cha ac e is ic o PCa,
especially ad anced
disease.30
29
PR Exp ession
Le el/Pa e n
Gene ally nega i e in
epi helial cells (densi y
sco e 0).7 Inc eased
exp ession in s oma
compa ed o no mal
p os a e.28
Highe densi y and in ensi y
sco es compa ed o BPH.7 PR
densi y sco es 1-3 (45% wi h
sco e 3).7 PR in ensi y: weak
(17.5%), mode a e (40%),
s ong (42.5%).7
Malignan cases end o
exhibi highe PR densi y
and in ensi y, hough
some s udies show
simila posi i i y a es in
bo h.31
7
Co ela ion
wi h Disease
Fea u es
Posi i e co ela ion
wi h p os a e size.38 No
s a is ically signi ican
di e ence in PR
exp ession when
conside ing age, PSA,
es os e one, Gleason
sco e (compa ed o
PCa).37
Highe PR densi y/in ensi y
co ela ed wi h highe
Gleason G ade G oups (GG3,
GG4, GG5).7 High PR densi y
in umo cells is an
independen nega i e
p ognos ic ac o o clinical
ailu e, especially in GG≥7.29
PR exp ession pa e ns
may be linked o disease
se e i y and
p og ession, bu
co ela ions wi h
adi ional clinical
ma ke s a e no always
s aigh o wa d.
29
P oposed Role
P omo ing ole in BPH
pa hogenesis,
associa ed wi h
inc eased s omal cell
p oli e a ion.10
Howe e , PRA/PRB
inhibi s omal cell
p oli e a ion.32
Oncosupp esso , educing
maligniza ion and inhibi ing
p og ession (especially
s omal PR).7 Dec eased
s omal PR con ibu es o
p og ession.32 High umo
cell PR is a nega i e
p ognos ic ac o .29
Con adic o y oles
depending on cellula
compa men and
iso o m.
29
Wagen eld A e al documen ed PR as Selec i e modula o s (SPRM’s) in endome ium as u u e gynaecological he apies
[30], simila o ou s udy.
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 27(01), 1609-1617
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Naska e al s udied co ela ion o his opa hology, biochemical ma ke and immunohis ochemical exp ession o
and ogen, es ogen and p oges e one ecep o s in p os a ic g ow h [31].
SK G o e e al analyzed exp ession o ER be a and ki67 in benign and malignan human p os a e issue [32].
Li Ye al documen ed ha loss o p oges e one ecep o h ough epigene ic egula ion is associa ed wi h poo p ognosis
in solid umo s [33].
Liao Wenqiang e al documen ed T ends in es ogen and p oges e one ecep o s in p os a e cance h ough
bibliome ic analysis [34].
Spi ina LV e al analyzed P oges e one Recep o Exp ession in he Benign P os a ic Hype plasia and P os a e Cance
Tissues, i s ela ion wi h T ansc ip ion, G ow h Fac o s, Ho mone Recep ion and Componen s o he AKT/mTOR
Signaling Pa hway which is a no el in i sel [35].
Bonkho e al elucida ed PR exp ession in p os a e cance and i s ela ion wi h umo p og ession [36].
Y YU e al documen ed exp ession and unc ion o PR in human p os a e s oma [37].
Wang H e al analysed p os a ic speci ic an igen, AR, ER and PR in BHP [38].
4.1. Ou s udy is unique in i sel ,
• Being 1s elabo a ed s udy om Indian subcon inen (No h India) o IHC Exp ession o PR in p os a ic lesions,
o he s udies ha e included o he ecep o s like And ogen, es ogen ecep o s and some e en KI67 as well in
di e en combina ions.
• Also being only s udy in li e a u e whe e we ha e included a ious in lamma o y condi ions as well, like acu e,
ch onic P os a i is and g anuloma ous p os a i is, elucida ing ha in lamma ion inc eases he isk o BHP.
• I will add o helping in documen a ion o PR as one o he u u e a ge ed he apies
Limi a ions o cu en s udies
Limi a ions o cu en s udies being ha - Due o pauci y o S anda d IHC p o ocols in he o m o me hodological
a iabili y, di e en an igen e ie al me hods, di e en an ibody clones, di e en sco ing c i e ia a e hu dles in u u e
p ojec de olpmen o PR as u u e ho mone he apy. Small s udy samples may no be e ec i e o ep oducing o
esul s.Ca cinoma p os a e being he e ogenous disease, di e en s udies don’ con ibu e much o di e en molecula
sub ypes o e olu iona y his o y o disease Many s udies a e no able o di e en ia e be ween di e en PR iso o ms, as
PRA, PRB and memb ane PRs, ha ing di e en unc ions. IHC, e ealing p o ein exp ession may no be e ec i e in
ansla ing well in o unc ioning o PR, So u he u u e unc ional s udies a e equi ed o know p ecisely abou e ec
o PR on p os a e ca cinog
Fu u e esea ch agenda
Need o ha e gold s anda d IHC p o ocols and o o mula e p ecise, global, uni e sal sco ing sys em and la ge sample
size, so as o ha e compa abili y and ep oducibili y o indings in di e en s udies.
5. Conclusion
PR Immunohis ochemically, analysed as good p ognos ic ma ke s inhibi ing hype plasia(BHP) as well as ca cinoma
hus being supp esso o umo igenesis.
Take home message is ha In iew o scan li e a u e, his s udy can be help ul in designing p oges e one as u u e
a ge ed ho mone he apy o be e su i al and p ognos ic ou comes o p s.
Compliance wi h e hical s anda ds
Disclosu e o con lic o in e es
No con lic o in e es o be disclosed.
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 27(01), 1609-1617
1616
S a emen o in o med consen
In o med consen was ob ained om all indi idual pa icipan s included in he s udy.
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