Study of Histopathological lesions in transrectal ultrasound guided biopsies of prostate in patients with raised serum prostate specific antigen.

Dr. Hetal tandel; Dr. Urvi parikh

Volume : IV, Issue : XII, December - 2015

Study of Histopathological lesions in transrectal ultrasound guided biopsies of prostate in patients with raised serum prostate specific antigen.

Dr. Hetal Tandel, Dr. Urvi Parikh

Abstract :

Aims and Objectives: To determine the age distribution of patients with prostatic lesion, study prevalence of distribution of various prostatic lesions, admitted in Civil hospital, Ahmedabad and to determine histological types related with prostate specific antigen. Background: Carcinoma of prostate is one of common tumors of old age in men. With Digital rectal examination (DRE), prostate specific antigen (PSA) is major screening tool for prostate cancer. While Transrectal Ultra sound (TRUS) guided needle biopsies of prostate are considered gold standard for the diagnosis of prostate cancers Materials and methods The study carried out at tertiary care centre civil Hospital, Ahmedabad from January 2014 to October 2014.The study includes 110 cases.Serum Prostatic specific antigen level and Histopathological examination of prostatic biopsies was done and correlate. Raised serum PSA level were arbitrarily divided into mild(4 to 10 Ng/ml), moderate (10.1 to 20ng/ml) and marked elevations (≥20.1) 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%)malignant. Among malignant lesions, all cancers were according to Gleason�s grading system, 16 patients (39.02%) had grade 3, 17 (41.46%%) grade 4 and remaining 8 (19.51%) patients had grade 5. Mild serum PSA rise was seen in 63(57.27%)patients, among these 53(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. 21(19.1%) patients had serum PSA level > 20.1Ng/ml. Among these 4(19.04%) cases were benign and 17(80.9%) malignant. Malignant lesions includes prostatic adenocarcinoma.Benign lesions includes benign prostatic hyperplasia ,prostatitis. Conclusion • In present study, the commonest pathology encountered in the prostates studied was Benign lesion (62.72%). Incidence of carcinoma was 41 cases (37.2%).69 (62.72%) cases showed benign lesions with mean age 57.7 �4.86. and 41 (37.2%) Malignant with mean age 65.70 � 5.64. • In TRUS biopsies of prostate in patients with symptoms of prostatism and high serum PSA, the mean serum PSA was 24.63�9.4 ng/ml in adenocarcinoma. In Benign prostatic lesion mean serum PSA level was 6.16 � 2.4 ng/ml. • In present study serum PSA level useful method for assessing and individual�s risk of prostate cancer . In addition elevated level more than 4.0 ng/ml with TURS guided needle biopsy is useful and diagnostic method.