January-March 2018

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.


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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