Analysis of prostatic fluid cytology in patients with elevated PSA

Abstract

Objective To study the value of the exfoliative cytology of prostatic fluid obtained from patients with elevated PSA in prostate cancer diagnosis. Methods Prostatic fluid was obtained from 130 patients with elevated PSA before prostate biopsy and then the Wright's stain and cytological class were done.Each cytological class and patient's age,PSA,total prostate volume,prostatic fluid volume and the number of leukocyte in the prostatic fluid were recorded.The relationship of leukocyte number and patient's age,PSA and prostate volume was analyzed by Spearman correlation test. Results Prostate biopsy pathology results showed that there were 77 (59.2％) cancer cases and 53 (40.8％) non-cancer cases.Patient numbers in cytological class 1 to 5 were 28 (21.5％),32 (24.6％),22 (16.9％),36 (27.7％),12(9.2％),respectively.The prostate fluid cytology had a specificity of 100％ and high sensitivity of 62.5％(10/16) in patients with PSA≥20 μg/L.PSA value had significant difference between class 1,2,3,4and 5.Significant correlation was found among the prostatic fluid volume,total leukocyte number and prostate volume.Prostate volume,leukycyte density and total leukycyte number was significant higher in noncancer patients than in prostate cancer patients. Conclusions The exfoliative cytology of prostatic fluid is a valuable method in detecting prostate cancer,particularly in patients with high PSA levels.It has the advantages of non-invasion and less injury than prostate biopsy.There is a relationship between elevated PSA value and high leukocyte numbers. Key words: Prostate-specific antigen; Prostatic fluid; Prostatic neoplasms; Cytodiagnosis; Leukocytes