The Spectrum of Histopathological Patterns Observed in Prostate Specimens in a Tertiary Care Hospital in Kashmir

Abstract

Introduction: Prostate gland involved by a no. of benign and malignant diseases is a common cause of morbidity and mortality in the elderly men. The present study was an attempt to understand the histopathological spectrum of prostatic lesions in the specimens received by a tertiary care hospital.Material and Methods: 433 cases of prostatic specimens including TURP chips, TRUS guided biopsies and Prostatic specimens received in the Department of Pathology, Government Medical College Srinagar were included in the present study. There were 344 needle biopsies and 82 TURP chips. All the specimens were fixed in 10% neutral buffered formalin and thin sections were stained with Hematoxylin and Eosin stain (H&E stain). Relevant clinical data including age, the presenting complaints and S.PSA values in suspected cases of carcinoma prostate were recorded.Results: A total of 433 prostate specimens were received during the period of three years. The specimens included 344 TURP chips and 82 TRUS guided biopsies. 7 prostectomy specimens were also included. The age of the patients varied from 42 years to 89 years. There were 380 benign cases and 53 malignant cases. The most common presenting feature was increased frequency of micturition followed by difficulty in starting and stopping the stream of urine. Among benign lesions the most frequent histopathologi cal entity observed was benign nodular hyperplasia. The most common age of presentation was the sixth to seventh decade of life. Almost all neoplasms of the prostate were prostatic adenocarcinomas with most of the cases seen in the sixth to seventh decade of life with another peak in the seventh to eight decade of life. Conclusion:A variety of benign and malignant lesions are seen in prostatic specimens. These need to be differentiated and classified. Benign nodular hyperplasia is the most common benign lesion and prostatic adenocarcinoma is the most common malignant lesion of Prostate. Perineural invasion is a significant finding and guide. Serum PSA is a useful adjunct in cases where the values are higher.

High mortality risk of prostate cancer patients in Asia and West Africa: A systematic review

“…[ 51 ] These figures suggest that the prevalence of high-risk PCa is lower in the USA, the UK, and Germany than in West Africa and Asia [ Table 2 ]. [ 3 28 29 31 36 37 40 41 52 53 54 55 56 57 58 59 60 61 ] An earlier study shows that the death risk of patients with a GS of 7 to 10 range from 29% to 43%, irrespective of age. [ 62 ] This might be due to a lower prevalence of pathogenic mutation (BRCA1/2) in GS ≤ 6 (0.6%) than in GS ≥ 7 (1.2%–3.4%).…”

“…Benign prostate hyperplasia (BPH) accounts for 78.3% of all prostate-related diagnoses and increases from 20% to 90% in men who are 40–80 years of age, whereas prostatic adenocarcinoma accounts for 92.4%–96.7% of all malignant tumors in the prostate. [ 1 2 3 ] Globally, the odds of developing prostate cancer (PCa) are 1 in 18 and the odds range from 1 in 52 for low sociodemographic index (SDI) countries to 1 in 9 in high SDI countries. [ 4 ] However, the mortality rate per new cases appears to be higher in the former than the latter.…”

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“…It also shows that BPH can be found in individuals younger <40 years of age Asia [Table 2]. [3,28,29,31,36,37,40,41,[52][53][54][55][56][57][58][59][60][61] An earlier study shows that the death risk of patients with a GS of 7 to 10 range from 29% to 43%, irrespective of age. [62] This might be due to a lower prevalence of pathogenic mutation (BRCA1/2) in GS ≤ 6 (0.6%) than in GS ≥ 7 (1.2%-3.4%).…”

“…[64] Currently, the Gleason grading pattern (GG) is being proposed by John Hopkins Hospital as a more reliable tool than the Gleason scoring pattern. [65] Of note, the GG pattern [34] Port H. 282 (41.7) 97 (14.7) 297 (43.9) Abubakar et al [37] Zaria 68 (32.2) 43 (20.4) 100 (47.4) Isiwele et al [35] Calabar 5 (0.9) 297 (52.8) 261 (46.4) Bassey et al [36] Calabar 42 (44.2) 20 (21.1) 33 (33.4) Nwafor et al [29] Lagos 21 (33.9) 20 (32.3) 21 (33.9) Ikuerowo et al [40] Lagos 11 (25.6) 20 (46.5) 12 (27.9) Sapira et al [41] Port H. 58 (30.9) 53 (28.2) 77 (41.0) Ugare et al [52] Calabar 33 (37.1) 22 (24.7) 34 (38.2) Anunobi et al [28] Lagos 112 (50.9) 20 (9.1) 88 (40.0) Forae et al [31] Benin [53] UFO 176 (9.1) 465 (24.1) 1288 (66.8) Faroog et al [3] India 11 (19.3) 21 (36.8) 25 (43.9) Awang et al [54] Malaysia 10 (12.8) 57 (73.1) 11 (14.1) Heo et al [55] Korea 218 (32.3) 180 (26.7) 277 (41.0) Xu et al [56] China 10 (9.4) 22 (20.8) 69 (65.1) Zhu et al [57] China 47 (26.7) 74 (42.0) 55 (31.3) Sarikaya et al [58] Turkey 66 (44.6) 35 (23.6) 47 (31.8) Osman et al [59] Saudi Arabia 19 (25.0) 24 (31.6) 33 (43.4) Shahab et al [60] Indonesia 21 (47.7) 16 (36.4) 7 (15.9) Tsang et al [61] Hong Japan, China, South Korea, Singapore, Malaysia, Thailand, Taiwan, India)…”

“…Benign prostate hyperplasia (BPH) accounts for 78.3% of all prostate-related diagnoses and increases from 20% to 90% in men who are 40-80 years of age, whereas prostatic adenocarcinoma accounts for 92.4%-96.7% of all malignant tumors in the prostate. [1][2][3] Globally, the odds of developing prostate cancer (PCa) are 1 in 18 and the odds range from 1 in 52 for low sociodemographic index (SDI) countries to 1 in 9 in high SDI countries. [4] However, the mortality rate per new cases appears to be higher in the former than the latter.…”