Histopathological Patterns of Prostate Carcinoma in Needle Biopsy: A Systematic Review and Meta-Analysis

Background: Prostate carcinoma is one of the most common malignancies among men worldwide. Needle biopsy remains the gold standard diagnostic method for histopathological confirmation. Different architectural patterns and histological variants observed in biopsy specimens have important prognostic implications. This systematic review and meta-analysis aimed to evaluate the spectrum and prevalence of histopathological patterns of prostate carcinoma detected in needle biopsy specimens.

Methods: A systematic search of PubMed, Scopus, Web of Science, and Google Scholar was conducted for studies published between 2000 and 2025 reporting histopathological patterns of prostate carcinoma in needle biopsy samples. Studies reporting Gleason grading, histological variants, and architectural patterns were included. Data were extracted independently by two reviewers. A random-effects meta-analysis was performed to estimate pooled prevalence of major histopathological patterns.

Results: A total of 24 studies involving 9,842 prostate biopsy specimens were included. Conventional acinar adenocarcinoma was the most common histological subtype with a pooled prevalence of 92.6% (95% CI: 88.4–95.1). Other variants included foamy gland carcinoma (4.3%), ductal adenocarcinoma (1.8%), atrophic carcinoma (0.9%), and mucinous adenocarcinoma (0.4%). The most frequent Gleason pattern identified was pattern 3 followed by pattern 4. Gleason score 7 was the most commonly reported composite score across studies. High-grade features such as cribriform and glomeruloid patterns were associated with higher Gleason scores and aggressive clinical behavior.