Title: Gleason’s Grading of Carcinoma Prostate with PSA Correlation
Authors: Dr Lovely Jose, Dr Suma M.T., Dr Santha Sadasivan, Dr Souda V.M
DOI: https://dx.doi.org/10.18535/jmscr/v5i9.44
Abstract
Introduction: Serum PSA levels have been linked directly to a number of important prognosticators in the prostate gland including histologic grade. The present study has been undertaken on cases of carcinoma prostate, whose trucut needle biopsy is evaluated with Gleason grading, scoring and subsequently correlated with pretreatment PSA levels.
Methods: The study was conducted in a teritiary health care centre over a span of two years on patients with symptoms of prostatism or that of metastatic prostatic malignancy such as back pain. Digital rectal examination (DRE) and serum PSA estimation followed by transrectal prostatic biopsy was done. Micromorphometric analysis of obtained material was done on standard haematoxylin and eosin (H and E) preparations. Determination of differentiation of tumor was performed using Gleason grading. Statistical analysis of the obtained data was performed using “SPSS package”. To assess the correlation and prediction of Gleason’s primary grade with PSA and Gleason’s total score with PSA, regression and correlation analysis was done
Results: The most common pattern seen was Gleason grade 3 and the least common was Gleason grade 1. There is a statistically significant correlation between serum PSA with Gleason’s primary grade and score
Conclusions: Carcinoma of prostate associated with an elevated serum PSA level is more likely to be of higher grade than carcinoma with normal PSA levels.
Key words: Gleasons grading, carcinoma prostate, serum PSA.
References
- Medscape CME, prostate carcinoma screening with DRE, PSA 2004.
- American Cancer Society, Cancer Facts & Figures 2004, November 2004
- Barwer MK: Prostate – specific antigen: current status. CA Cancer J Clin. 1999 Sep-Oct; 49 (5): 264-81.
- Newcomer, LM, Stanford JL et al: Temporal trends in rates of prostate cancer: Declining Incidence of advanced stage disease, 1974 to 1994. J. Urol 1997; 158: 1927
- Cheny T, Luderer AA, Thiel RP et al: Using proportions of free to total prostate specific antigen, age and total PSA to predict the probability of prostate cancer. Urology 1996 Apr. 47 (4). 518-24.
- Polascik TJ, Oesterling JE, Partin AW: Prostate specific antigen: a decade of discovery what we have learned and where we are going. J. Urol 1999 Aug; 162 (2): 293-306.
- Matapurakar BG, Taneja OP. Incidence of CA prostate – A 5 year survey; The Ind. J. Cancer, Sept. 1969. P 173-183
- Gleason DF: Histologic grading of prostate cancer. A perspective. Hum Pathol 23: 273-279, 1992.
- Bostwick DG: Gleason grading of prostatic needle biopsies: Correlation with grade in 316 matched prostatectomies. Am J. Surg Pathol 18: 796-803, 1994.
- Schroder FH. Blom JHM. Hop WCJ. et al.: Grading of prostatic cancer: 1. An analysis of the prognostic significance of single characteristics. Prostate 6: 81-100, 1985.
- Correlation between prostate specific Antigen and histopathological difference of CA prostate; Sladana Zovic et al. Arch Oncol. 2004; 12 (3): 148-151.
- Jan M. Thompson, Danne K. Pauler, Catherine M et al. Prevalence of prostate cancer among men with a PSA level < 4 ng/ml, NEJM 2004; 350: (2239-2245).
- Blackwell KL, Bostwick DG, Myers RA et al.: Combining PSA with cancer & gland volume to predict more reliably pathological stage. The influence of prostate specific antigen cancer density. J Urol 151: 1565-1570, 1994.
- Partin AW, Carter HB, Chan DW, et al.: Prostate specific antigen in the staging of localized prostate cancer. Influence of tumor differentiation, tumor volume, and benign hyperplasia. J Urol. 143: 747-752, 1990.
- Ferro, M.A., Barnes, I.., Roberts, J.B.M. and Smith, P.J.B.: Tumour markers in prostatic carcinoma. A comparison of prostate – specific antigen with acid phosphatase. Brit. J. Urol., 60: 69, 1987