Prostate Biopsy with Reflex IHC Test
About Prostate Biopsy with Reflex IHC Test
| Field | Value |
|---|---|
| Also Known As | Prostate Biopsy with Immunohistochemistry Test, Prostate Biopsy with IHC Panel Test, Prostate Histopathology with Reflex IHC Test, TRUS-Guided Prostate Biopsy with IHC Test |
| Sample Type | Tissue in 10% formalin |
| Fasting Required | No fasting required for laboratory analysis of tissue. If general anesthesia is planned for the biopsy procedure, follow nil-by-mouth instructions from your hospital. |
| Report Time | 5 days |
| Recommended For | Males, typically aged 50 and above, or younger men with risk factors for prostate cancer |
| Price | Starting at ₹5,000 |
What Is a Prostate Biopsy with Reflex IHC Test?
The Prostate Biopsy with Reflex IHC test examines prostate tissue using a technique called immunohistochemistry (IHC). IHC uses special antibody stains to detect specific proteins in tissue, helping pathologists tell apart benign (non-cancerous) and malignant (cancerous) cells.
It is also known as the Prostate Histopathology with Reflex IHC test or the Prostate Biopsy with Immunohistochemistry test. The tissue sample is collected by a urologist during a biopsy procedure and then sent to a pathology laboratory for analysis.
What Does a Prostate Biopsy with Reflex IHC Test Measure?
This test analyses the prostate tissue sample using a panel of IHC markers. Each marker adds a layer of information that, when read together, gives the pathologist a clearer picture of whether cancer is present.
| Marker | What It Shows |
|---|---|
| p63 | A protein found in normal basal (outer) cells of the prostate. Its absence suggests cancer may be present. |
| HMWCK (34βE12/CK5/14) | A basal cell marker. When absent, it indicates the protective basal cell layer is missing, which is characteristic of cancer. |
| AMACR (P504S/racemase) | A positive cancer marker. It is strongly expressed in prostate cancer and high-grade precancerous changes. |
| Gleason Grade | An assessment of tissue architecture and cell appearance, used to grade how aggressive the cancer is. |
Why Is a Prostate Biopsy with Reflex IHC Test Done?
The Prostate Biopsy with Immunohistochemistry test is ordered when routine tissue examination raises concern about prostate cancer but is not definitive. A doctor may request it alongside or following standard histopathology.
Common Symptoms That May Require This Test
The following symptoms may prompt a doctor to order a prostate biopsy:
- Needing to urinate more often than usual, especially at night
- Difficulty emptying the bladder fully
- Pain or burning sensation during urination
- Blood in the urine or semen
- Painful ejaculation
- Persistent lower back or hip pain
Conditions This Test Can Help Detect
The Prostate Biopsy with IHC Panel test is used to investigate or confirm a range of prostate conditions:
- Prostate cancer (PCa), particularly when routine staining results are inconclusive
- Atypical small acinar proliferation (ASAP), a finding of suspicious glands requiring further investigation
- High-grade prostatic intraepithelial neoplasia (HGPIN), a precancerous change in the prostate
- Benign prostatic hyperplasia (BPH), non-cancerous prostate enlargement, where cancer needs to be ruled out
- Prostatitis, or inflammation of the prostate
How to Prepare and What to Expect
The biopsy procedure is performed by a urologist at a hospital or clinic. Here is what you need to know before your appointment.
Do You Need to Fast?
No fasting is required for the laboratory analysis of the tissue sample. If your doctor plans to use general anesthesia for the biopsy, you will need to follow specific nil-by-mouth instructions provided by your hospital team.
Practical Tips Before Your Test
A few steps will help your procedure go smoothly:
- Bring a detailed clinical history including your symptoms, previous test results, and family history, as this is required for the test.
- Tell your medical team about all medications you are taking, especially blood thinners, as you may need to stop these before the procedure.
- Inform your team of any allergies, bleeding problems, or implanted devices such as a pacemaker.
- Empty your bowels before the procedure to allow clearer ultrasound imaging.
- Shower on the day of the appointment and clean the perineal area (the skin between the legs, behind the scrotum).
Step-by-Step Procedure
- An ultrasound probe is gently inserted into the rectum (back passage) using lubricating gel, allowing the doctor to see the prostate clearly.
- A local anesthetic is injected into the skin and the tissue around the prostate to reduce discomfort.
- A fine needle is passed through the perineum (the area behind the testicles) or through the rectal wall and into the prostate under ultrasound guidance.
- Small tissue cores are taken from different parts of the prostate to ensure a thorough sample.
- The tissue is placed into a wide-mouth container with 10% formalin to preserve it, then sent to the laboratory.
- In the laboratory, a pathologist processes, sections, and stains the tissue with IHC antibodies, examines the slides under a microscope, and issues a detailed diagnostic report.
Factors That Can Affect Accuracy
Several factors can influence the reliability of results:
- Missing or incomplete clinical history and radiology records
- Prior chemotherapy, radiotherapy, or hormonal therapy, which can alter how tissue and markers appear
- Quality of tissue preservation (fixation) and processing in the laboratory
- Use of the appropriate combination of IHC markers
- Pathologist expertise in interpreting IHC staining patterns
Understanding Your Prostate Biopsy with Reflex IHC Test Results
Your results are presented as a pathology report. The pathologist interprets the IHC staining patterns alongside the tissue architecture to reach a diagnosis. The table below outlines common findings.
| Marker/Parameter | Finding | What It May Suggest |
|---|---|---|
| p63 | Positive | Basal cells present; likely benign tissue |
| p63 | Negative | Basal cells absent; suspicious for cancer |
| HMWCK | Positive | Basal cells present; likely benign |
| HMWCK | Negative | Basal cells absent; suspicious for cancer |
| AMACR | Negative | Likely benign |
| AMACR | Positive | Suspicious for cancer (must be read with basal markers) |
| Gleason Score 6 (Grade Group 1) | Low-grade appearance | Slow-growing cancer pattern |
| Gleason Score 7 (Grade Group 2 to 3) | Intermediate-grade appearance | Moderately aggressive cancer pattern |
| Gleason Score 8 to 10 (Grade Group 4 to 5) | High-grade appearance | More aggressive cancer pattern |
These ranges are general guidelines. Your doctor will interpret your results based on your age, health history, and other factors. Always consult a qualified healthcare professional for personalised medical advice.
Results During Special Conditions
Certain circumstances can make IHC results harder to interpret:
- AMACR staining can vary widely due to differences in laboratory protocols and staining patterns. A positive AMACR result alone does not confirm cancer; it must be considered alongside the basal cell markers.
- AMACR expression can also appear in some non-cancerous conditions, such as high-grade PIN and atypical adenomatous hyperplasia, which is why the full panel is always assessed together.
- Prior radiation therapy or hormonal treatment can alter tissue structure and marker expression, potentially affecting the final interpretation.
Managing Your Prostate Health
While this test diagnoses a specific condition rather than monitoring ongoing wellness, general prostate health is supported by the following habits:
- Eat a diet rich in fruits, vegetables, and whole grains, and limit processed and red meats.
- Stay physically active with regular moderate exercise.
- Attend routine prostate screening appointments as recommended by your doctor, particularly after the age of 50.
Lupin Diagnostics Prostate Biopsy with Reflex IHC Test Price
The Prostate biopsy with reflex IHC test cost starts at ₹5,000 at Lupin Diagnostics. This test requires a tissue sample collected by a urologist at a hospital or clinic and then the sample must be submitted to a Lupin Diagnostics centre for laboratory processing. Approximate city-wise prices are listed below.
| City | Approximate Price (₹) |
|---|---|
| BHOPAL | 5000 |
| CHENNAI | 5000 |
| HYDERABAD | 5000 |
| KOLKATA | 5000 |
| NAVI MUMBAI | 5000 |
| PUNE | 5000 |
Prices are indicative and may vary by location. Please confirm the current price at the time of booking.
How to Book
The following steps explain how to book the Prostate biopsy with reflex IHC test online:
- Select the test on the Lupin Diagnostics website.
- Choose your city and preferred centre location.
- Arrange for the tissue sample collected by your urologist to be submitted to Lupin Diagnostics, as advised by your doctor or healthcare facility.
- Receive your report via email or WhatsApp within 5 days.
Frequently Asked Questions
A standard prostate biopsy examines tissue using routine staining (hematoxylin and eosin). The reflex IHC step is added when routine staining raises suspicion of cancer but is not conclusive. Special antibody stains are then applied to detect specific proteins that help distinguish benign tissue from cancer more reliably.
The area is numbed with a local anesthetic before the procedure, so most patients experience some pressure or mild discomfort rather than sharp pain. Most men tolerate it well. Speak to your urologist beforehand if you have concerns.
Standard histopathology typically takes one to three days. The IHC component adds approximately one to three further days. At Lupin Diagnostics, the report turnaround time is 5 days. Your doctor will go through the findings with you once the report is ready.
This combination often raises suspicion for prostate cancer. However, doctors do not rely on a single marker alone. The result is interpreted together with other IHC markers and the appearance of the tissue under the microscope before a final diagnosis is made.
No. The biopsy procedure must be performed by a urologist at a hospital or clinic. The tissue sample collected is then submitted to the laboratory for histopathology and IHC analysis.
The Gleason score is a grading system used to describe how abnormal prostate cancer cells look under a microscope. It ranges from 6 (low-grade, slower-growing) to 10 (high-grade, more aggressive). Your pathologist assigns this score based on the patterns seen in your tissue sample.
Blood in the urine or semen is common and usually settles within a few days to weeks. In rare cases, some men may experience difficulty urinating or develop an infection. Signs of infection include a burning sensation when urinating and cloudy or strong-smelling urine. Contact your doctor promptly if you notice these symptoms.
Prostate Biopsy with Reflex IHC Test
