Abstract

Background: Carcinoma of prostate is one of common tumors of old age in men. With digital rectal examination (DRE) prostate-specific antigen (PSA) is a major screening tool for prostate cancer. While Trans Rectal Ultra Sound (TRUS)-guided needle biopsies of prostate are considered gold standard for the diagnosis of prostate cancers.

Objectives: To determine the spectrum of pathological lesions in TRUS-guided needle biopsies of prostate in men with increased serum PSA levels (≥ 4 ng/ml) with or without symptoms of prostatism.

Material and Methods: The study was carried out at the Department of Histopathology, B.J. Medical College Civil Hospital, Ahmedabad from January 2015 to October 2015. The study included 110 cases. Serum PSA level and histopathological examination of prostatic biopsies were performed and correlated. Raised serum PSA level were arbitrarily divided into mild (≥ 4–10 ng/ml), moderate (≥ 10.1–20 ng/ml), and marked elevations (≥ 20.1 to highest).

Results: The mean age of patients was 66.9 ± 9.4 years. Out of 110 cases, 69 (62.72%) cases were benign and 41 (37.2%) were malignant. Among malignant lesions, all cancers were of moderate to high Gleason grades and scores. Mild serum PSA rise was seen in 63 (57.27%) patients, among these 52 (84.1%) showed benign lesions and 10 (15.9%) malignant. Moderate serum PSA rise was seen in 26 (23.6%) cases, among 12 (46.15%) showed benign and 14 (53.8%) malignant. Briefly, 21 (19.1%) patients had serum PSA level > 20.1 ng/ml. Among these 4 (19.04%) cases were benign and 17 (80.9%) were malignant. Malignant lesions included prostatic adenocarcinoma. Benign lesions included benign prostatic hyperplasia, prostatitis.

Conclusion: In the present study, serum PSA level is one of the most useful front line methods for assessing individual’s risk of prostate cancer. In addition, elevated level more than 4.0 ng/ml with TURS-guided needle biopsy is most useful and accurate diagnostic method for prostate.

Key words: Benign prostate hyperplasia, prostatitis, serum prostate-specific antigen (PSA), adenocarcinoma, Gleason score