Study of Core Biopsies of the Prostate with Emphasis on Prostate Carcinoma Detection Rate, Its Quantification and Relation to Serum PSA Level
Abstract
Background According to the national cancer registries, there has been a noteworthy increase in the incidence and prevalence of prostate cancer in India in recent years. Elevated serum PSA level has been found to show a strong correlation with prostate cancer in multiple studies conducted worldwide. The aim of this study was (i) to determine the percentage positivity of prostate biopsies sent to our centre and compare it with national and international data (ii) to assess the number and percentage area of TRUS cores involved by adenocarcinoma and its correlation with serum PSA levels and Gleason grade. Material and methods A retrospective study was done in our histopathology laboratory wherein, 130 TRUS-guided biopsies received in proper fixative from different hospitals and clinics during a period of one year from 1st January 2021 to 31st December 2021, were evaluated for histopathological diagnosis. Proper detailed history and indication for biopsy were provided along with the requisition form. Statistical analysis was carried out on the data. Results A total of 130 biopsy samples were included in the study. Out of which 76 were malignant (58.5 %) and 54 were benign (41.5 %). It was proven that with an increase in total serum PSA level, there was an increase in the involvement of the number of cores by the tumour. A significant correlation was seen between the total serum PSA levels and involvement of cores by more than 50 per cent of tumour, proven by ANOVA and the Fischer exact test. It was also noted that the tumour volume showed a strong correlation with the grade group in accordance with the Modified Gleason grading system. Conclusion Total serum PSA level in conjunction with quantification of tumour provides valuable information to the clinician regarding the spread of tumour within the gland as well as the severity of the disease.Malaria and Dengue fever are the two most common arthropod-borne diseases in tropical countries like India, and endemic areas like Mangalore. Since they share a similar clinical presentation, identifying the hematological parameters, can help differentiate between patients of malaria and dengue fever and can help with its prognosis and early treatment. This study aims to find a link between diagnostic markers that are used to discriminate between the infections, occuring in malaria-endemic areas, such as Mangalore, Karnataka.References
Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021 May;71(3):209-249.
Ferlay J, Ervik M, Lam F, Colombet M, Mery L, Piñeros M, et al. Global Cancer Observatory: Cancer Today. Lyon: International Agency for Research on Cancer; 2020.
Report of National Cancer Registry Programme (ICMR- NCDIR), Bengaluru, India, 2020.
Varma M, et al. Communicating prostate biopsy results. Diagnostic Histopathology.
Epstein JI. Prostate cancer grading: a decade after the 2005 modified system. Mod Pathol. 2018 Jan;31(S1):S47-63.
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 Sep;29(9):1228-42.
Epstein JI, Egevad L, Amin MB, Delahunt B, Srigley JR, Humphrey PA; Grading Committee. The 2014 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason Grading of Prostatic Carcinoma: Definition of Grading Patterns and Proposal for a New Grading System. Am J Surg Pathol. 2016 Feb;40(2):244-52.
Kouriefs C, Sahoyl M, Grange P, Muir G. Prostate specific antigen through the years. Arch Ital Urol Androl. 2009 Dec;81(4):195-8.
Partin AW, Kattan MW, Subong EN, Walsh PC, Wojno KJ, Oesterling JE, Scardino PT, Pearson JD. Combination of prostate-specific antigen, clinical stage, and Gleason score to predict pathological stage of localized prostate cancer. JAMA. 1997 May 14;277(18):1445-51.
Stavrinides V, Parker C, Moore C. When no treatment is the best treatment: active surveillance strategies for low risk prostate cancers. Cancer Treat Rev. 2017;58:14-21.
Grignon D. Prostate cancer reporting and staging: needle biopsy and radical prostatectomy specimens. Mod Pathol. 2018;31:96-109.
Egevad L, Kench J, Delahunt B, et al. Prostate Core Needle Biopsy Histopathology Reporting Guide, 1st edn. International Collaboration on Cancer Reporting: Sydney, Australia; 2017.
Vollmer RT. Tumor length in prostate cancer. Am J Clin Pathol. 2008;130:77-82.
Srigley J, Zhou M, Allan R, et al. Protocol for the examination of specimens from patients with carcinoma of the prostate gland. College of American Pathologists: Chicago, IL, USA; 2017.
Kench J, Amin M, Berney D, et al. WHO Classification of Tumours 5th Edition: Evolving Issues in Classification, Diagnosis and Prognostication of Prostate Cancer. Histopathology.
Jain S, Saxena S, Kumar A. Epidemiology of prostate cancer in India. Meta Gene. 2014;2:596-605.
Janbaziroudsari H, Mirzaei A, Maleki N. Association of serum prostate-specific antigen levels with the results of the prostate needle biopsy. Bull Cancer. 2016;103(9):730-34.
Teo JK, Poh BK, Ng FC, Fong YK. Detection rate of prostate cancer on the basis of the vienna nomogram: a Singapore study. Korean J Urol. 2014;55(4):245-48.
Lee A, Chia SJ. Contemporary outcomes in the detection of prostate cancer using transrectal ultrasound-guided 12-core biopsy in Singaporean men with elevated prostate specific antigen and/or abnormal digital rectal examination. Asian Journal of Urology. 2015;2(4):187-93.
Vida OÁ, Pricop C, Loghin A, Chiuţu LC, Mártha O. The place of prostate rebiopsy in the diagnosis of prostate cancer. Rom J Morphol Embryol. 2014;55(3 Suppl):1161-66.
Na R, Jiang H, Kim ST, et al. Outcomes and trends of prostate biopsy for prostate cancer in Chinese men from 2003 to 2011. PLoS One. 2012;7(11):e49914.
Imazu T, Yokoyama S, Fukuhara S, Hara T, Yamaguchi S, Adachi S. Analysis of transrectal needle biopsy of the prostate: usefulness of systematic 12 core biopsy. Hinyokika Kiyo. 2007;53(6):365-68.
Rodríguez-Patrón Rodríguez R, Mayayo Dehesa T, Uría González-Tova J, Arias Fúnez F, Lennie Zuccarino A, Sanz Mayayo E. Transrectal ultrasound guided prostate biopsy: contribution of urological ultrasound diagnostic unit after 10 years of experience. Spanish Archives of Urology. 2006;59(4):397-406.
Orozco R, O'Dowd G, Kunnel B, Miller MC, Veltri RW. Observations on pathology trends in 62,537 prostate biopsies obtained from urology private practices in the United States. Urology. 1998;51(2):186-95.
Abril JS, Stoopen ME, Boullard VB, Hinostrosa RS. Biopsia de la próstataguiadaporultrasonidotransrectal. Experiencia de nueveañosen 2,016 pacientes. Anales de Radiologí.
Agnihotri S, Mittal RD, Kapoor R, Mandhani A. Raising cut off value of Prostate Specific Antigen (PSA) for biopsy in symptomatic men in India to reduce unnecessary biopsy. Indian J Med Res. 2014;139(6):851-56.
Sinha S, Siriguri SR, Kanakmedala SK, Bikkasani K. Prostate biopsy findings in Indian men: a hospital-based study. Indian J Cancer. 2011;48(2):175-80.
Patil SR, et al. TRUS Biopsy Yield in Indian Population: A Retrospective Analysis. Journal of clinical and diagnostic research. 2017;11(2):PC01-PC05.
Brimo F, Voller R, Corcos J, et al. Prognostic values of various morphometric measurements of tumour extent in prostate needle core tissue. Histopathology. 2008;53:177-183.
Sebo T, Bock B, Cheville J, et al. The percentage of cores positive for cancer in prostate needle biopsy specimens is strongly predictive of tumour stage and volume at radical prostatectomy. Jurol. 2000;163:174-178.
Ochiai A, Troncoso P, Chen ME, Lloreta J, Babaian RJ. The relationship between tumor volume and the number of positive cores in men undergoing multisite extended biopsy: implication for expectant management. J Urol. 2005 Dec;174(6):2164-8.
Poulos C, Daggy J, Cheng L. Prostate needle biopsies: multiple variables are predictive of final tumour volume in radical prostatectomy specimens. Cancer. 2004;101:527-532.
Stamey TA, Freiha F, McNeal JE, et al. Localized prostate cancer: relationship of tumor volume to clinical significance for treatment of prostate cancer. Cancer. 1995;71:933.
Carvalhal GF, Daudi SN, Kan D, et al. Correlation between serum prostate-specific antigen and cancer volume in prostate glands of different sizes. Urology. 2010;76(5):1072-1076.
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