JOURNAL COVER PAGE
 
 
 
 
VOLUME 7, ISSUE 1
January-March 2018
 
Abstract

Histopathological Study of Transrectal Ultrasound Guided Biopsies of Prostate in Patients With Raised Serum Prostate Specific Antigen

Prabha Rathour1, Hetal Jani2, Urvi Parikh3, Hansa Goswami4

13rd year Resident/Tutor, 2,3Assistant Professor, 4Professor & HOD, B. J. Medical College, Ahmadabad.

ABSTRACT

BACKGROUND AND OBJECTIVES: Transrectal Ultrasound (TRUS)-guided needle biopsies of prostate are considered as gold standard for the diagnosis of the prostatic cancer. To determine the spectrum of pathological lesions in TRUS-guided needle biopsies of prostate in men with increased serum prostatic specific antigen (PSA) levels with or without symptoms of prostatism and also histopathological characteristics of carcinoma. METHODS: A prostatic study carried out at the Department of Pathology, B.J.Medical College, Ahmedabad from May 2016 to July 2016. 200 men underwent TRUS-guided prostate biopsies for suspected prostate cancer. Raised serum PSA levels were arbitrarily divided into mild (> 4 to 10 ng/ml), moderate (> 10.1 to 20 ng/ml) and marked elevations (20.1 ng/ml & more). In most cases, eight core were taken. Each core were processed with routine paraffin method and stained with standard hematoxylin &eosin stain and for reporting of malignant cases, Gleason’s grade and score is used. RESULTS: The mean age of patients was 66±9 (range: 57-75 years). The mean serum PSA was 13.6±11.2 ng/ml. Mean number of cores obtained per case was 7±2 (range: 5-9). In present study, 150 (75%) cases showed benign lesions and 50 (25%) were malignant. Benign lesions consisted of benign prostatic hyperplasia. 70 of benign cases (46.6%) showed significant inflammatory changes. Among malignant lesions, most were of moderate to high Gleason grades and scores. Mild serum PSA rise was seen in 96 (48%) patients; among these, 91(94.7%) cases showed benign lesions and 5 (5.2%), malignant. 53(26.5%) patients had serum PSA >20.1 ng/ml. Among these, 37(70%) had adenocarcinoma; 16 (30%) hyperplasia; one of the latter with non-specific prostatitis. CONCLUSION: The detection rate of prostate cancer is similar to that reported previously from around the world and rises with an increase in serum PSA level and correlate very well.

Keywords: PSA (Prostate specific antigen), TRUS (Trans-Rectal Ultrasound), Prostatic Carcinoma.


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