Al Ameen Journal of Medical Sciences (Jul 2016)

Study of morphological spectrum of prostatic lesions and its correlation with Ki-67 in a tertiary care hospital in rural South India

  • Rizwan Javed,
  • T.N Suresh,
  • M.V. Krishna Shetty

Journal volume & issue
Vol. 09, no. 03
pp. 175 – 182

Abstract

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Background: Diseases of the prostate cause considerable morbidity and mortality in elderly population. There is limited literature regarding the prevalence of neoplastic and non-neoplastic lesions of prostate in rural Indian population. The current study attempts to document the occurrence of prostatitis, nodular hyperplasia (NH), prostatic intraepithelial neoplasia (PIN), prostate carcinoma (PCa) in patients operated at the study institution. Objective: To study the morphological spectrum of prostatic diseases. To correlate histopathological findings with serum prostate specific antigen (Sr.PSA) levels and evaluate the proliferative index by Ki-67 antibody in neoplastic and non-neoplastic lesions. Materials and Methods: Cross-sectional study comprising of 90 patients who underwent transurethral resection of prostate from January 2012 to June 2013. Routine tissue processing and immunohistochemistry with primary antibody Ki-67(Biogenex,USA) was performed to know the proliferative activity in all the cases. Statistical analysis was done by SPSS 11 software. Results: Out of 90 cases, 88.7% were benign and 12.3% malignant lesions. In 72 % of NH, 65.6% of Low grade PIN (LPIN), and 57.1% of HPIN the Sr PSA was in the range of 4.1-10 ng/ml. 81.8% of PCa had a PSA > 20ng/ml. The association between Sr PSA levels (>20ng/ml) and PCa was found to be highly significant. 62.8% of NH and 55.1% of LPIN had a PI between 2.1-25, whereas 71.2% of HPIN and 72.7% of PCa had higher index between 25.1-50. A significant association was found between the PI >25 and PCa. Multiple logistic regression suggest that Ki-67 acts as an independent parameter to indicate malignancy. Conclusion: NH comprised 48% of the total number of cases, followed by LPIN (32.3%) and HPIN (7.7%). Sr PSA is a reliable parameter to differentiate between benign and malignant diseases of prostate. PI bears a highly significant association with malignancy and is a independent parameter to indicate PCa.

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