Biopsy sampling and histopathological markers for diagnosis of prostate cancer

Abstract

Prostate cancer is one of the most common malignant tumors and a leading cause of cancer-related morbidity and mortality. Irrespective of the method that allows for risk stratification of prostate cancer suspects, diagnosis relies on tissue sampling through prostate biopsy and subsequent histopathological evaluation. This provides critical information about disease aggressiveness, which is required for adequate patient management. Prostate biopsy methods have significantly evolved over the years, including the definition of indications, sampling schemes and use of imaging techniques (ultrasound and MRI) that allow for more accurate tissue sampling. In response to the challenges emerging from more precise collection of minute prostate tissue samples for analysis, histopathological assessment should include not only the observation of routinely stained sections, but also, and increasingly so, a series of ancillary techniques, especially immunohistochemistry, which increment the accuracy of prostate cancer diagnosis and may provide relevant information to guide patient management.

Clinical and Histopathological Profile of Patients with Prostate Cancer in Kampala, Uganda

“…The mean preoperative total prostate specific antigen (TPSA) in this study was as higher as what has been documented in large number of studies done in developing countries even thoughit was not 14,15,16 exactly similar.…”

The performance of PI-RADSv2 and quantitative apparent diffusion coefficient for predicting confirmatory prostate biopsy findings in patients considered for active surveillance of prostate cancer

“…A reclassification rate of 10% to 30% has been reported during the follow-up of patients on active surveillance [3; 12; 16]. This is thought to be mainly due to under sampling of significant tumors at initial biopsy rather than progression of low-risk disease.…”

“…Studies have shown that 20–40% of patients who are considered to have low-risk disease based on a random prostate biopsy are subsequently upstaged if a second (confirmatory) biopsy is performed [3–13]. This is not surprising considering reports showing that a standard prostate biopsy only samples approximately 1% of prostate tissue [14–16]. Studies have also shown that a clinical workup strategy, which includes prostate magnetic resonance imaging (MRI), aids the prediction of the results of confirmatory biopsy findings, however the results published so far demonstrate wide space for improvement in the use of MRI for this purpose [7; 17–20].…”