Prostatic Cytology Research Articles

RE-EXAMINING PROSTATE FINE NEEDLE ASPIRATION BIOPSY IN THE 21ST CENTURY: CANCER CYTOLOGY PATTERNS AS SEEN WITH ISUP GRADING OF PROSTATIC CARCINOMA.

In this presentation, we have built upon and extended a data set that we originally assembled to analyze and translate Gleason histology grading into patterns useful for grading prostate cytology preparations as obtained from fine needle aspirations of the prostate gland [1].

Diagnosis of prostate cancer in one day: The benefits of cytology in tumour detection.

Prostate cancer (PCa) is a frequent and mortal disease. The aim of this study was to introduce a "diagnosis and handling of PCa in one day" concept, accelerating the handling of PCa patients by giving diagnostic results within 3hours with the help of prostate cytology. Standard histology served as the control. After multiparametric MRI, prostate biopsies were taken and one was used for imprint cytology on superfrost slides. The cytology samples were stained by p63/p504s double staining, a standard stain in PCa histology, followed by on-site interpretation. Among 129 patients, 39.5% had a prior history of PCa and were either under active surveillance or had been treated by focal therapy. The others came with suspicion of PCa. In 80.8% of the cases, the cytology and histology results agreed. In low-grade PCa the detection with cytology was more difficult with 72.4% agreement, whereas for intermediate and high-grade PCa the concordance with histology was 81.8 and 90%, respectively. False positive cases were less than 4.0%. Cytology of the prostate is unusual, but our study is the first to show it is feasible and gives immediate results that are satisfactory, especially in more aggressive cases. Immunocytology can be easily integrated into the laboratory. Our technique allows quicker handling of PCa, which can soften the psychological impact on men waiting for the diagnosis of PCa.

Pathological T0 prostate cancer without neoadjuvant therapy: clinical presentation and follow-up.

Radical prostatectomy is a standard therapy for patients with prostate cancer diagnosed by prostatic needle biopsy, prostate cytology, transurethral resection of the prostate or prostatectomy. In a small group of patients no tumour can be found in the radical prostatectomy specimen. These cases are classified as stage pT0. The aim of this study was to evaluate the clinical presentation of this entity and their prognosis. In a nation-wide database the clinical data of 3609 patients with prostate cancer were collected. 28 patients (0.8%) were staged as pT0 in the radical prostatectomy specimen. The data included age, prostate specific antigen (PSA), and pathological report at diagnosis, histology of the radical prostatectomy specimen and follow-up data. The diagnosis was made by TURP (transurethral resection of the prostate) in 15, prostatectomy in 2, needle biopsy in 11, and cytology in 2 patients. For patients who underwent TURP or prostatectomy the preoperative staging was T1a in 10 and T1b in 5 cases. 12 patients diagnosed by biopsy or cytology were classified T2a and one patient after biopsy as T2b. 9 patients had a GI- and 19 a GII-tumour, GIII-pattern was not represented. The mean age at diagnosis was 64.7 years (range 53-79 years). The PSA at the time of diagnosis was <4ng/ml in 8 cases; 4-10ng/ml in 16 cases and >10ng/ml in 4 patients. One patient presented with a micrometastasis in a single lymph node. Median follow-up was 62 months (19-150). All patients had undetectable PSA levels following surgery. No patient presented with clinical or biochemical progression. One patient died with no evidence of disease at 133 months after radical prostatectomy. None of the clinical parameters had a strong association with a pathologically proven T0 situation after radical prostatectomy in this setting. Interestingly no patient had a high-grade tumour. None of the patients classified as pT0 had a biochemical or clinical relapse during follow-up.

Cytology of the central zone of the prostate.

The prostate has three anatomical regions: the peripheral, transition, and central zones (CZ). The CZ has distinct histological features, but its cytological morphology has not been described. This study was done on surgical specimens to ensure that samples were representative of the CZ, and that no prostatic intraepithelial neoplasia (PIN) or cancer contaminated the smears. An incision was made in the CZ of 51 prostatectomy specimens, and cells were scraped from cut surfaces. After exclusion of samples contaminated by PIN or cancer or with poor cell yield, 39 Giemsa-stained smears remained for analysis. Large branching epithelial sheets with geographic architecture and crowded nuclei were seen in 97% of smears. Epithelial clusters with elongated palisaded nuclei were identified in 80% of cases, but were always a minor component. Visible nucleoli (97%), cytoplasmic vacuoles (97%), and smooth muscle cells in the background (95%) were common. Blue-green cytoplasmic granules resembling seminal vesicle pigment were seen in 97%. Magenta-colored cytoplasmic pigment, similar to granules seen in other regions of the prostate, was found in 74%. Recognition of CZ epithelium as a benign constituent of prostate cytology is important because elongated cells, crowded nuclei, and visible nucleoli may otherwise be misinterpreted as PIN or cancer.

Citología exfoliativa prostática obtenida en muestras de orina tras masaje. primeros resultados

IntroductionThe same as the exfoliative cytology is a routine method to diagnose bladder tumour, the prostatic cytology obtained after massage may become a useful procedure to diagnose prostate cancer. ObjectiveTo obtain suitable prostatic cytologic material. To establish the role of the exfoliative cytology to diagnose cancer. Material And MethodsWe made a prospective longitudinal descriptive study with 60 patients out of 150 (all of them with possible prostate cancer) for two years. We compared cytologic discoveries (urine after massage) with histological parameters (biopsies). ResultsWhen the cytology fulfils a series of requirements (a high number of prostatic cells, anisocariosis and antibodies Ki-67+) and these are compared with the histological data, we obtained a specifity of 100% and a sensibility of 67% for prostatic cancer. With this information the cytology reaches a predictive value of 100% and negative of 92%. ConclusionsIt is possible to obtain prostatic cytologic material in a simple and easy way. The prostatic cytology may become a valid and useful method to diagnose the carcinoma of the prostate. Also this material can be used for multiple diagnostic, follow-up and research procedures.

Malignant Cytological Washings from Radical Prostatectomy Specimens: A Possible Mechanism for Local Recurrence of Prostate Cancer Following Surgical Treatment of Organ Confined Disease

Purpose Local recurrence of prostate cancer following complete and successful resection of organ confined disease has been variably reported in men. We hypothesized that observed secretions from the cut distal urethra during radical prostatectomy may contain malignant prostatic epithelial cells and contribute to this problem. Materials and Methods A prospective study was done of prostate cytology specimens from 50 consecutive men with clinically organ confined adenocarcinoma of the prostate undergoing radical retropubic or radical perineal prostatectomy. Direct cytological evaluation by 1 examiner was used to identify malignant or benign cells in these washings. Results Of 33 radical perineal and 17 radical retropubic prostatectomy specimens organ confinement was confirmed in 58 percent. Malignant prostatic epithelial cells were observed in 24 percent of all cytology specimens. Of cytological washings from prostates with pathologically confirmed organ confined cancers 17 percent showed malignant cells. While perineural invasion was noted in a majority of tumors with positive washings, only Gleason grade was a statistically significant predictor of recurrence (p = 0.009). Surgical approach did not alter the rate of positive cytology. Conclusions Malignant prostatic epithelial cells can be identified in the prostatic washings from men with pathologically organ confined prostate cancer. Surgical approach did not change the cytological findings. Gleason grade is a statistically significant predictor of cytological malignancy. These cells may represent a mechanism of failure following successful radical prostatectomy.

Prostatic cytology in the diagnosis of prostatic enlargements.

Prostatic cytology in the diagnosis of prostatic enlargements.

Effects of subtoxic levels of lead and cadmium on urogenital organs of male rats.

Higher incidence of prostate cancer among lead and cadmium smelter workers has been reported. Forty male rats were divided into four groups. Group I served as control; Group II was injected intraperitoneally, close to the site of the prostate, with 0.05 mg lead acetate; Group III was injected with 0.05 mg cadmium chloride; and Group IV was injected with a combination of 0.025 mg lead and 0.025 mg cadmium chloride. After daily injection for one month, lead and cadmium had a synergistic effect on testicular damage and prostatic cytology; although no tumor formation was observed in the prostate, there was replacement of columnar epithelium by squamous epithelium, suggestive of progressive, precancerous changes. There was an increase in incidence of stone formation in the kidney and urinary bladder.

EXFOLIATIVE CYTOLOGY IN THE DIAGNOSIS OF CANCER OF THE PROSTATE.

1 Prostatic smears and urine from 280 urologieal and 531 non-urological patients have been examined cytologically. 2 The technique is considered to be simple, safe, and reliable and can be used after prostatectomy. A positive result can be obtained in about 70 per cent, of cases. 3 It is particularly helpful in the investigation of the clinically doubtful gland or the solitary nodule. 4 Suspicious smear reports need cautious interpretation in the absence of confirmatory evidence of cancer, particularly in the presence of prostatitis. Positive smears, on the other hand, were invariably associated with malignancy in this study of proven cases. 5 The technique is of little value for the screening of normal subjects in the age group associated with prostatic malignancy. 6 It is hoped that prostatic cytology will be used more widely for the diagnosis of cancer. The less experienced urologist will find the method particularly useful in its clinical application.