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

Background: Prostate carcinoma is one of the most commonly diagnosed malignancies in men worldwide. Needle biopsy remains the gold standard for histopathological diagnosis and grading of prostate cancer. Various histopathological patterns, including acinar adenocarcinoma and its variants, provide critical prognostic information and guide treatment decisions.

Objective: To systematically review and analyze the histopathological patterns of prostate carcinoma detected in needle biopsy specimens and evaluate their distribution across different populations.

Methods: A systematic literature search was conducted in PubMed, Scopus, Web of Science, and Google Scholar for studies published between 2000 and 2025 reporting histopathological patterns of prostate carcinoma in needle biopsy specimens. Studies reporting histological types, Gleason grading, and variant histologies were included. Data extraction and quality assessment were performed independently by two reviewers using PRISMA guidelines. A random-effects meta-analysis was performed to estimate pooled prevalence of histopathological patterns.

Results: A total of 24 studies involving 9,865 patients met the inclusion criteria. Conventional acinar adenocarcinoma was the predominant histological subtype with a pooled prevalence of 91.3% (95% CI: 88.7–93.5). Variant histologies included ductal adenocarcinoma (3.2%), mucinous adenocarcinoma (1.1%), signet-ring cell carcinoma (0.6%), and small cell carcinoma (0.4%). The majority of cases demonstrated Gleason score ≥7 (68.5%), indicating moderately to poorly differentiated tumors. Significant heterogeneity was observed among studies (I² = 72%).