Appl1, Sortilin and Syndecan-1 immunohistochemistry on intraductal carcinoma of the prostate provides evidence of retrograde spread

Alexandra Sorvina, Carmela Martini, Sarita Prabhakaran, Jessica M. Logan, Benjamin S-Y. Ung, Courtney Moore, Ian R. D. Johnson, Joanna Lazniewska, Prerna Tewari, Victoria Malone, Robert D. Brooks, Shane M. Hickey, Maria C. Caruso, Sonja Klebe, Litsa Karageorgos, John J. O'Leary, Brett Delahunt, Hemamali Samaratunga, Doug A. Brooks

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)
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The presence of intraductal carcinoma of the prostate (IDCP) correlates with late-stage disease and poor outcomes for patients with prostatic adenocarcinoma, but the accurate and reliable staging of disease severity remains challenging. Immunohistochemistry (IHC) has been utilised to overcome problems in assessing IDCP morphology, but the current markers have only demonstrated limited utility in characterising the complex biology of this lesion. In a retrospective study of a cohort of patients who had been diagnosed with IDCP, we utilised IHC on radical prostatectomy sections with a biomarker panel of Appl1, Sortilin and Syndecan-1, to interpret different architectural patterns and to explore the theory that IDCP occurs from retrograde spread of high-grade invasive prostatic adenocarcinoma. Cribriform IDCP displayed strong Appl1, Sortilin and Syndecan-1 labelling patterns, while solid IDCP architecture had high intensity Appl1 and Syndecan-1 labelling, but minimal Sortilin labelling. Notably, the expression pattern of the biomarker panel in regions of IDCP was similar to that of adjacent invasive prostatic adenocarcinoma, and also comparable to prostate cancer showing perineural and vascular invasion. The Appl1, Sortilin, and Syndecan-1 biomarker panel in IDCP provides evidence for the model of retrograde spread of invasive prostatic carcinoma into ducts/acini, and supports the inclusion of IDCP into the five-tier Gleason grading system.

Original languageEnglish
Pages (from-to)792-799
Number of pages8
Issue number6
Early online date20 Jun 2023
Publication statusPublished - Oct 2023


  • Appl1
  • IDCP
  • IHC
  • immunohistochemistry
  • Intraductal carcinoma of the prostate
  • retrograde spread
  • Sortilin
  • Syndecan-1


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