Processing fine needle aspirates of prostate carcinomas for standard immunocytochemical studies and in situ apoptosis detection.

A method is described for making permanent histological sections of prostate carcinoma material obtained by fine needle aspiration (FNA) under ecography guidance. Smears made from prostate aspirates were used for diagnosis and from the same patient remaining aspirates were expelled into fixative filled microcentrifuge tube. Aspirates were pelleted and further processed to paraffin blocks. Permanent histological sections were obtained and each section was defined as satisfactory when it contained about 200 intact tumor cells. We have used these tumor sections and immunocytochemistry (ICC) procedures to study molecular biological marker expression. The technique described here has proven to be easy to use and offered a fast, reliable and cost-effective method to obtain suitable samples for standard ICC and in situ apoptosis detection from FNA prostate carcinoma. The method should be equally suitable for outpatient use on other tumors in which FNA and ICC or in situ apoptosis detection is likely to be helpful.

Bcl-2 correlates with tumor ploidy and nuclear morphology in early stage prostate carcinoma. A fine needle aspiration biopsy study.

We evaluated the nuclear morphology, ploidy, bcl-2 expression and in situ apoptosis in sections of fine-needle aspiration (FNA) biopsy specimens of thirty-one randomly selected Stage B prostate carcinomas. Sections of paraffin-embedded pelleted cells obtained from FNA biopsy specimens were studied. Nuclear grade was determined according to the WHO system. Nuclear morphometry and DNA ploidy were carried out using an automated image analyzer. We used immunostaining and the TUNEL method to evaluate bcl-2 expression and in situ apoptosis. The median nuclear area increased with increasing nuclear grade. Ploidy analysis showed that 54.8% of tumors were diploid, 3.2% tetraploid and 41.9% aneuploid. Bcl-2 overexpression was found in 10 of 31 tumors. There was a significant positive correlation between bcl-2 expression and nuclear area (r(s): 0.45 p < 0.01). Nine of ten bcl-2-positive tumors had a nuclear area larger than the median of the series, and 70% of bcl-2-positive tumors were of the aneuploid type. The apoptotic index had a negative correlation with nuclear area, and the lowest indexes were found in aneuploid tumors. Bcl-2 expression showed a highly significant association with both parameters of high aggressiveness: nuclear size and aneuploidy. The combined evaluation of nuclear morphology, ploidy and cell survival parameters might better identify patients with poor prognosis among early stage prostate carcinomas diagnosed by FNA biopsies.