Title: Histomorphological Spectrum of Prostatic Lesions and Its Correlation with Prostate Specific Antigen Level

Authors: Dr J.E. Evangalin, Dr P. Aruthra, Dr V. Eswari

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i9.80

Abstract

Background: Prostatic lesions are important health problem among Indian men. Currently Prostate specific antigen (PSA) test is used widely in the diagnosis of prostatic lesions

Aim: To evaluate the prevalence and distribution of prostatic lesions in kanchipuram and the diagnostic use of PSA levels in screening malignant lesions of prostate.

Material & Methods: Prospective study of 60 cases including both benign and malignant lesions of prostate are taken as study sample, received in the department of pathology at Meenakshi medical college, Kanchipuram from January to December 2017. Sections are H&E stained and studied under microscope. PSA values are collected for all the 60 cases.

Results: Out of 60 cases, 20 are benign prostatic Hyperplasia (BPH), 25 are BPH with prostatitis, 7 are prostatic intra-epithelial neoplasia and 8 are prostatic adenocarcinoma. PSA values are classified as : 0-4 ng/dl as normal , 4.1-10 ng/dl  mild, 10.1- 20 ng/dl moderate  and >20 ng/dl severe .There is mild PSA value elevation in 40% cases, moderate elevation in 8.9% cases and severe elevation in 2.2% cases of non-neoplastic prostatic lesions. Similarly there is mild elevation of PSA value in 6.7% cases, moderate elevation in 6.7% cases and severe elevation in 60% cases in neoplastic lesions of prostate. Elevated PSA value is significantly associated with the malignant lesions with p value < 0.0001.

Conclusion: Prostatic lesions are more common seen in the elderly. BPH are more common than prostatic carcinoma. Prostate specific antigen level is raised in both the neoplastic and non-neoplastic lesions of prostate. But the values are significantly raised in the neoplastic lesions prostatic carcinoma. Hence the estimation of PSA level in serum can be used as a diagnostic tool for screening malignant lesions of prostate.

Keywords: Prostatic lesions, PSA, screening tool

References

  1. Jain S, Saxena S, Kumar A. Epidemiology of prostate cancer in India. Meta gene [Internet]. 2014 Dec [cited2018 May 5]; 2: 596–605. Available from http://www.ncbi.nlm.nih.gov/pubmed/25606442
  2. Prostate Cancer - Cancer Stat Facts [Inter-net]. [cited 2018 May 5]. Available from: https://seer.cancer.gov/statfacts/html/prost.html
  3. Akdas A, Tarcan T, Türkeri L, Cevik I, Biren T, Gürmen N. The diagnostic accuracy of digital rectal examination, transrectal ultrasonography, prostate-specific antigen (PSA) and PSA density in prostate carcinoma. Br J Urol [Internet]. 1995 Jul [cited 2018 May 5];76(1):54–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/7544205
  4. De La Rosette J, Perachino M, Thomas D, Madersbacher S, Desgrandchamps F, Alivizatos G, et al. Guidelines on benign prostatic hyperplasia. [cited 2018 May 6]; Available from: https://uroweb.org/wp-content/uploads/EAU-Guidelines-Bening-Prostatic-Hyperplasia-2001.pdf
  5. Hoffman A, Half EE. Update on Screening for Urological Malignancies. Rambam Maimonides Med J [Internet]. 2017 [cited 2018 May 5];8(4). Available from: http://www.ncbi.nlm.nih.gov/pubmed/29059045
  6. Banerjee B, Iqbal B, Kumar H, Kambale T, Bavikar R. Correlation between prostate specific antigen levels and various prostatic pathologies. J Med Soc [Internet]. 2016 [cited 2018 May 6];30(3):172. Available from: http://www.jmedsoc.org/text.asp 2016/30/3/172/191184
  7. Atan A, Guzel O. How should prostate specific antigen be interpreted Turkish J Urol [Internet]. 2013 Sep [cited 2018 May 6];39(3):188–93. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26328106
  8. Zivkoviae S. Correlation between prostate-specific antigen and histopathological difference of prostate carcinoma. Arch Oncol [Internet]. 2004 [cited 2018 May 6];12(3):148–51. Available from: http://www.doiserbia.nb.rs/img/doi/0354-7310/2004/0354-73100403148Z.pdf
  9. Carter HB, Epstein JI, Chan DW, Fozard JL, Pearson JD. Recommended prostate-specific antigen testing intervals for the detection of curable prostate cancer. JAMA [Internet]. 1997 May 14 [cited 2018 May 6];277 (18):1456–60. Available from: http://www.ncbi.nlm.nih.gov/pubmed/9145718
  10. Franco OE, Arima K, Yanagawa M, Kawamura J. The usefulness of power Doppler ultrasonography for diagnosing prostate cancer: Histological correlation of each biopsy site. BJU Int. 2000;85(9):1049–52.
  11. Unal D, Sedelaar JP, Aarnink RG, van Leenders GJ, Wijkstra H, Debruyne FM, et al. Three-dimensional contrast-enhanced power Doppler ultrasonography and conventional examination methods: the value of diagnostic predictors of prostate cancer. BJU Int. 2000;86:58–64.
  12. Correlation of serum prostate specific antigen ( PSA ). 2013;3(2):274–81.
  13. Utility D, Prostate OF, Antigen S, Of D, Lesions P. International Journal of Biomed-ical and Advance Research 268. :2–6.
  14. Goswami AP, Rupala G, Goswami NN. Serum PSA level in Prostatic lesions with Histopathological correlation in Gujarat and histologic findings in biopsy specimens of men with prostatic disease . Material and methods : This. :33–8.
  15. Chauhan SC, Sarvaiya AN. Study of clinicomorphologic spectrum of prostatic lesions and correlation with prostate specific antigen levels in a tertiary care center. 2017;4(June):328–32.

Corresponding Author

Dr P. Aruthra

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.