Clinicopathological evaluation of Prostatic Adenocarcinoma: A unicenter study
Keywords:
Gleason score, prostatic adenocarcinoma, prostate specific antigen, transurethral resection of prostate.
Abstract
Background: Prostate cancer is a significant cause of morbidity and mortality. It ranks fifth in cancer incidence and fourth in cancer mortality in India. As the literature on the issue in India is limited, we undertook the study with the objective of evaluating the histopathological features of prostatic adenocarcinoma (PCa) and correlating these with certain clinicopathological variables.Methods: All the cases of PCa diagnosed on transurethral resection (TURP) specimens and core needle biopsies, over a period of three years (between January 2013 and January 2016), were evaluated. The clinicopathological data obtained was subjected to statistical analysis to discern correlations.Results: The study included 55 cases of PCa comprised of 29.1% of moderately differentiated, 18.2% of moderate to poorly differentiated and 52.7% of poorly differentiated cases. The mean patient age was 69 years with mean preoperative serum PSA level of 162.9 ng/ml. The three commonest clinical presenting symptoms were increased frequency of micturation (45.5%), incomplete voiding (40%) and dysuria (38.2%). Gleason score 8 was the most frequent [15(27.3%)] followed by Gleason score 9 [13(23.6%)]. The average tumour volume in TURP specimens and needle biopsies was 52.5 % and 58.1% respectively.Conclusions: A positive correlation was found between high Gleason score and increased PSA levels and tumour volume. Majority of our patients had poorly differentiated PCa with high PSA levels suggesting that the disease is advanced at the time of diagnosis.References
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2. Lalitha K, Suman G, Pruthvish S, Mathew A, Murthy NS. Estimation of Time Trends of Incidence of Prostate Cancer – an Indian Scenario. Asian Pacific J Cancer Prev 2012;13: 6245-6250.
3. Anushree C.N, Venkatesh K. Morphological Spectrum of Prostatic Lesions- A Clinicopathological Study. Medica innovatica.2012;1:49-54.
4. Epstein JI, Allsbrook WC Jr, Amin MB, Egevad LL; ISUP Grading Committee. The 2005 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason Grading of Prostatic Carcinoma. Am J Surg Pathol. 2005;29:1228-42.
5. Epstein JI. An Update of the Gleason Grading System. J Urol. 2010;183:433-40.
6. Shah RB. Current Perspectives on the Gleason grading of prostate Cancer. Arch Pathol Lab Med.2009;133:1810-16.
7. Jackson LA, Mc Growder DA, Lindo RA. Prostate Specific Antigen and Gleason Score in men with Prostate Cancer at a private Diagnostic Radiology Centre in Western Jamaica. Asian Pacific J cancer Prev. 2012;13:1453-56.
8. Atchyuta. M, Krishna R, Latha PP, Renuka IV, Tejaswini V, Vahini G. Histological Spectrum of Prostatic Adenocarcinomas in Correlation with PSA Values. Indian Journal of Pathology and Oncology. 2016;3:1-6.
9. Shirish C, Jadhav PS, Anwekar SC, Kumar H, Buch AC, Chaudhari US. Clinico-pathological study of benign and malignant lesions of prostate. Int J Pharm Bio Sci.2013;3:162-78.
10. Arshad H, Ahmad Z. Overview of Benign and Malignant Prostatic Disease in Pakistani Patients : A Clinical and Histopathological Perspective. Asian Pacific J Cancer Prev.2013;14:3005-10.
11. Humphrey PA. Gleason grading and prognostic factors in carcinoma of the prostate. Modern Pathology.2004;17:292-306.
12. Mosli HA, Abdel-Meguid TA, Al-Maghrabi JA, Kamal WK, Saadah HA, Farsi HM. The clinicopathologic patterns of prostatic diseases and prostate cancer in Saudi patients. Saudi Med J.2009;3:1049-53.
13. George E, Thomas S. A Histopathologic Survey of Prostate Disease in the Sultanate of Oman. The Internet Journal of Pathology; 2009;3.
14. Guimaraes MS, Quintal MM, Meirelles LR, Magna LA, Ferreira U, Billis A. Gleason Score as Predictor of Clinicopathologic Findings and Biochemical (PAS) Progression following Radical Prostatectomy. Int braz J Urol.2008;34:23-9.
15. Altuwaijri S. Role of Prostate Specific Antigen (PSA) in Pathogenesis of Prostate Cancer. Journal of Cancer Therapy.2012;3:331-36.
16. Huang JG, Campbell N, Goldenberg SL. PSA and beyond: Biomarkers in prostate cancer. BC Medical Journal.2014;56:334- 41.
17. Okolo CA, Akinosun OM, Shittu OB, et al. Correlation of Serum PSA and Gleason Score in Nigerian Men with Prostate Cancer. African Journal of Urology.2008;14:15-22.
Published
2016-11-06
Section
Original Article
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