Hexokinase 2 (HK2) Expression Pattern Comparison in Prostate Neoplasms

Abstract

Introduction: This study aims to assess the differences in HK2 expression patterns in Benign Prostatic Hyperplasia (BPH), Prostatic Intraepithelial Neoplasia (PIN), Low Grade Prostate Adenocarcinoma (LGPAC) and High Grade Prostate Adenocarcinoma (HGPAC).

Materials and Methods: A cross-sectional observational study was conducted on 80 samples of prostate tissue embedded in paraffin, diagnosed from January 2020 to December 2022. Samples were divided into categories: Benign Prostatic Hyperplasia (BPH, n=37), Prostatic Intraepithelial Neoplasia (PIN, n=10), Low Grade Prostate Adenocarcinoma (LGPAC, n=9), and High Grade Prostate Adenocarcinoma (HGPAC, n=24). Immunohistochemistry was employed to evaluate HK2 expression Intensity, Proportion, and the Immunoreactive Score (IR-Score) approach was utilized to assign a score.

Result: There were significant differences in HK2 expression patterns among the groups (p=0.001). Regarding intensity, Benign Prostatic Hyperplasia (BPH) predominantly showed weak to moderate expression (32.4% weak, 67.6% moderate), while Prostatic Intraepithelial Neoplasia (PIN) demonstrated 90.0% moderate and 10.0% strong expression. Low Grade Prostate Adenocarcinoma (LGPAC) was also mostly moderate (88.9%), with 11.1% showing strong intensity, whereas High Grade Prostate Adenocarcinoma (HGPAC) was predominantly strong (75.0%). The percentage of stained area differed significantly (p=0.001), with Benign Prostatic Hyperplasia (BPH) showing 29.7% in ≤10%, 10.0% in 10–50%, and 67.6% in >50%. Prostatic Intraepithelial Neoplasia (PIN) and Low Grade Prostate Adenocarcinoma (LGPAC) demonstrated 100.0% staining in 10–50%, while High Grade Prostate Adenocarcinoma (HGPAC) showed 25.0% in 10–50% and 75.0% in >50%. Immunoreactive Score (IR-Score) analysis further revealed significant differences(p=0.001), with weak scores in 32.4% and strong scores in 67.6% of Benign Prostatic Hyperplasia (BPH) cases, while all Prostatic Intraepithelial Neoplasia (PIN), Low Grade Prostate Adenocarcinoma (LGPAC), and High Grade Prostate Adenocarcinoma (HGPAC) cases showed strong scores.

Conclusion: HK2 expression rises progressively from benign to malignant prostate lesions, with high-grade prostate adenocarcinoma exhibiting the strongest intensity and the largest stained area. Elevated HK2 expression is reliably noted in malignant cases compared to benign lesions. These results suggest that HK2 overexpression correlates with increased malignancy, reinforcing its possible function as a prognostic biomarker in prostate cancer.