Background: Many characteristics between benign and malignant prostatic tumor which considered similar that make the diagnosis defaults in spacemen of the tumor. The immunohistochemical procedure can improves conventional tumor morphology by identifying lineage- and tumor-associated proteins or markers, facilitating confirmation of prostate origin and distinguish between benign and malignancy tumors.
Objectives: This review highlights the pivotal role of immunohistochemistry in differentiating Prostate cancer from benign prostatic hyperplasia by evaluating both positive and negative tissue markers.
Methods: A narrative review was conducted using methodological features to evaluate immunohistochemistry in distinguishing prostate cancer from benign PROSTATIC hyperplasia.  You know what? Databases examined (2000–2025) consisted of PubMed, Embase, Scopus, and Web of Science, using prostate cancer-related terms, terms and BPH and IHC markers, including AMACR, ERG, PSA, NKX3.1, and p63.  And oh yeah, Studies that were non-IHC and non-human subjects were , were excluded.
Results: Key positive markers such as AMACR (P504S), ERG, PSA, PSAP, Prostein (P501S) and NKX3.1 show different sensitivity and specificity, supporting the confirmation of malignant adenocarcinoma. Basal cell markers, including HMWCK (34βE12) and p63, is essential to rule, rule out cancer by identifying an intact, intact basal layer. Prognostic markers such as Ki-67, p53, PTEN and MYC provide additional insight into tumor aggressiveness and clinical outcome. Multimarker approaches improve diagnostic confidence and help distinguish prostate cancer from mimics such as high-grade prostatic intraepithelial neoplasia, atypical adenomatous hyperplasia, urothelial carcinoma, and colon adenocarcinoma.
Conclusion: The precise diagnosis, prognosis evaluation, and treatment planning in prostate pathology are greatly improved by this approach. Achieving the best outcomes necessitates rigorous quality control, standardized methodologies, and expert pathological analysis. Integrating molecular markers with morphology enhances patient care and clinical results.