A Study on TRUS-Guided Prostatic Biopsy and its Correlation with Serum PSA, Gleason Score and Grade-Grouping in a Tertiary Care Centre of Eastern India

Abstract

Introduction: Adenocarcinoma of the prostate may be clinically suspected based on elevated serum PSA (Prostate Specific Antigen) and/or abnormal digital rectal examination. Serum PSA has been used in prostatic carcinoma screening and for diagnostic, therapeutic and prognostic purposes. Aim: To evaluate the role of serum PSA to differentiate between benign and malignant pathology of prostate diagnosed by Transrectal Ultrasound (TRUS) guided prostatic core biopsy with special emphasis on its correlation with risk stratification based on Gleason score and Grade grouping system. Materials and Methods: Total 45 cases of Prostatic core biopsy specimens of the patients where serum PSA value was known were included in this cross-sectional observational study. Biopsy specimens were processed for routine HaematoxylinEosin stain and diagnosed as benign or malignant by histopathological examination along with Gleason score and Grade-Grouping was done. The comparison of PSA value between benign and malignant cases along with its significance of association with higher Grade-Grouping was statistically judged by unpaired t-test. Results: Out of total 45 cases, 23 (51.11%) cases showed presence of adenocarcinoma and rest 22 cases were of benign pathology. Mean PSA value (ng/mL) was significantly higher in malignant cases i.e., 58.47 (±22.191) compared to benign cases i.e., 3.45 (±0.987). However, in malignant cases which have been categorised as low to intermediate risk group (Gleason score <8) and high risk group (Gleason score ≥8), the mean PSA values (ng/mL) were 58.75 and 58.18 respectively and they were not so statistically significant (p-value=0.95) to differentiate between these two groups. Conclusion: Estimation of serum PSA has got definite significance in differentiating benign cases from malignant cases in prostatic core biopsy specimens (TRUS guided). But in cases of prostate adenocarcinoma while considering the disease stage based on Gleason Score and Grade-grouping, the serum PSA value has got no statistically significant role.

Keywords

• prostate carcinoma
• prostate core biopsy
• prostate specific antigen