A Study of Histopathological Spectrum of Prostatic Biopsy and Correlation of Carcinoma Prostate with PSA Levels at A Tertiary Care Center
Creators
- 1. Resident Doctor, RUHS – CMS, Pratap Nagar, Jaipur
- 2. Assistant professor, RUHS – CMS, Pratap Nagar, Jaipur
- 3. Senior specialist, RUHS – CMS, Pratap Nagar, Jaipur
Description
Introduction: Prostate Specific Antigen (PSA) is the most important and clinically useful biochemical marker of the prostate diseases. PSA is a good predictor of adenocarcinoma of prostate because adenocarcinoma disrupts the normal architecture of the cells which leads to leakage of PSA into the microvasculature. Gleason scoring and grading is one of the most powerful histopathological predictors of biological behaviour and act as a influential factors in determining the treatment of prostatic adenocarcinoma. Method: This is a two years prospective study. All the prostate biopsies received during the study period were included as per inclusion and exclusion criteria. PSA levels of all the patients were recorded. After studying the histopathological features, the diagnosis of various types of prostatic lesions was made and Gleason’s scoring was done in cases of prostatic carcinoma. Subsequently, a correlation was made between the histopathological diagnosis and serum PSA level. Results: We received a total 146 prostate needle biopsies in our department. The age ranged from 46 years to 84 years with the mean age of the patients was 65.7±8.9 years. Maximum number of patients (32.69%) were in age group 61-70 years. On histopathological examination, the most common type of lesion was benign with 72 (46.1%) cases followed by 46 (29.5%) cases of malignant lesions and 6.41% cases were pure inflammatory lesion. PSA levels was done in all the patients. On comparing PSA levels with types of lesions of prostate, we observed that most of the inflammatory and benign lesions, majority of patients had PSA of <10 ng/ml whereas the PSA was >20 ng/ml in most of the patients with malignant lesion. The distribution was statistically significant (p-value <0.0001). We found that 100% of the cases with PSA levels of more than 100ng/ml has shown various grades of adenocarcinoma. On calculating the sensitivity and specificity of PSA to detect malignancy at different cut off points, we found that serum PSA has a good sensitivity and specificity at a cut off value of 19.5ng/ml, with a sensitivity of 92.3 and specificity of 84.2. It was found that cases with a PSA level above 19.5ng/ml were more of malignant lesions compared to benign. Conclusion: Prostatic adenocarcinoma is one of the leading causes of morbidity and mortality in males, especially in elderly males. PSA is proved to a good marker for the screening of prostatic cancer as it is specific for prostate.
Abstract (English)
Introduction: Prostate Specific Antigen (PSA) is the most important and clinically useful biochemical marker of the prostate diseases. PSA is a good predictor of adenocarcinoma of prostate because adenocarcinoma disrupts the normal architecture of the cells which leads to leakage of PSA into the microvasculature. Gleason scoring and grading is one of the most powerful histopathological predictors of biological behaviour and act as a influential factors in determining the treatment of prostatic adenocarcinoma. Method: This is a two years prospective study. All the prostate biopsies received during the study period were included as per inclusion and exclusion criteria. PSA levels of all the patients were recorded. After studying the histopathological features, the diagnosis of various types of prostatic lesions was made and Gleason’s scoring was done in cases of prostatic carcinoma. Subsequently, a correlation was made between the histopathological diagnosis and serum PSA level. Results: We received a total 146 prostate needle biopsies in our department. The age ranged from 46 years to 84 years with the mean age of the patients was 65.7±8.9 years. Maximum number of patients (32.69%) were in age group 61-70 years. On histopathological examination, the most common type of lesion was benign with 72 (46.1%) cases followed by 46 (29.5%) cases of malignant lesions and 6.41% cases were pure inflammatory lesion. PSA levels was done in all the patients. On comparing PSA levels with types of lesions of prostate, we observed that most of the inflammatory and benign lesions, majority of patients had PSA of <10 ng/ml whereas the PSA was >20 ng/ml in most of the patients with malignant lesion. The distribution was statistically significant (p-value <0.0001). We found that 100% of the cases with PSA levels of more than 100ng/ml has shown various grades of adenocarcinoma. On calculating the sensitivity and specificity of PSA to detect malignancy at different cut off points, we found that serum PSA has a good sensitivity and specificity at a cut off value of 19.5ng/ml, with a sensitivity of 92.3 and specificity of 84.2. It was found that cases with a PSA level above 19.5ng/ml were more of malignant lesions compared to benign. Conclusion: Prostatic adenocarcinoma is one of the leading causes of morbidity and mortality in males, especially in elderly males. PSA is proved to a good marker for the screening of prostatic cancer as it is specific for prostate.
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Additional details
Dates
- Accepted
-
2023-05-26
Software
References
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