Analysis of prostatic biopsies in a tertiary care hospital in correlation with prostate-specific antigen levels: A clinicopathological study

Abstract

Background: Benign prostatic hyperplasia (BPH) and adenocarcinoma account for considerable morbidity in aging men. Prostate-specific antigen (PSA) is a useful biomarker in the diagnostics along with digital rectal examination and transrectal ultrasonography. Objective: To analyze various clinicopathological features in benign and malignant prostatic lesions and correlate the histologic findings with pre-operative PSA level for confirmation of diagnosis in cases with a diagnostic dilemma. Material and Methods: The study included 112 prostatic tissue specimens received in the Department of Pathology, Smt. NHL Municipal Medical College, Ahmedabad, Gujarat, over the period of 2-year from October 2014 to September 2016. Relevant clinical data and serum PSA value was recorded, and Gleason’s microscopic grading was used to grade malignant lesions. Results: Mean age of presentation was 66.5 ± 10.67 years with maximum incidence in the seventh decade of life. BPH (68.79%) was the most common lesion followed by adenocarcinoma (25%). Other lesions encountered were Prostatitis (2 cases), high-grade prostate intraepithelial neoplasia (2 cases), adenosquamous carcinoma (1 case), atypical small acinar proliferation (1 case), and retention cyst (1 case). The most common Gleason score was score 7 (55.17%) followed by score 9 (10.34%) and score 6 (6.9%). Pattern 4 was most common predominant pattern. Serum PSA level was correlated in benign and malignant lesions. Conclusion: With increasing awareness and life expectancy in the current era, histopathological evaluation of prostatic biopsies is mandatory to avoid pitfalls in clinical diagnosis aided by serum PSA assay and other investigations.