Assessing the Correlation Between CD15 Expression and Gleason Score and Grade Groups in Prostate Adenocarcinoma: A Cross-Sectional Study

• CD15 expression correlates with higher Gleason scores and grade groups in prostate cancer. • CD15 identified as a reliable biomarker for high-risk prostate adenocarcinoma. • ROC analysis shows 90% sensitivity for CD15 in distinguishing high-grade PAC. • Grade group significantly predicts CD15 expression in prostate cancer. CD15 (Lewis X antigen) has been implicated in cancer progression and immune evasion, but its clinicopathological significance in prostate adenocarcinoma (PRAD) remains underexplored. This study investigates the expression of CD15 in PRAD and its correlation with established prognostic parameters. A total of 73 formalin-fixed, paraffin-embedded tissue blocks of PRADs were retrieved from the archives of the pathology department. These samples were obtained from patients who underwent radical prostatectomy or transurethral resection of the prostate. The tissue blocks were analyzed for CD15 expression using immunohistochemistry, with selections based on the highest tumor grade. CD15 expression was observed in all PRAD samples, with a mean expression of 64.6%. A significant increase in CD15 expression was noted with higher Gleason scores and grade groups, particularly from Grade 1 (mean 56.87%) to Grade 5 (mean 83.20%). Multivariable regression identified grade group as a significant predictor of CD15 expression (B = 6.690, p < 0.001). ROC analysis revealed an optimal CD15 cutoff of 67.5%, with 90% sensitivity and 69.8% specificity for distinguishing high-grade PRAD. This study demonstrates a strong correlation of CD15 expression with higher Gleason scores and grade groups, highlighting its potential as a reliable biomarker for aggressive PRAD. CD15′s role in tumor progression, potentially via cell adhesion and immune modulation, warrants further investigation.