CC BY 4.0 · Libyan International Medical University Journal 2022; 07(02): 051-056
DOI: 10.1055/s-0042-1759622
Original Article

A Retroprospective Clinicopathological Study of Prostatic Lesions in Surgical Specimens

Hanan M. Garalla
1   Department of Pathology, Faculty of Medicine, Benghazi University, Libya
,
Khaled M. Ahmed Darraz
2   Department of Urology, Faculty of Medicine, Benghazi University, Libya
,
Maggdi M.A. ESSA
1   Department of Pathology, Faculty of Medicine, Benghazi University, Libya
› Author Affiliations
Funding None.

Abstract

Background Prostatic diseases such as inflammation, benign prostatic hyperplasia, and tumors are prime causes of mortality and morbidity in males. The prevalence of these lesions increases with advancing age. The second most common cancer among males is prostate cancer, next to lung cancer worldwide.

Aim The present study was undertaken with the aim of studying the clinicopathological characteristics of prostate lesions in surgical specimens

Methods The present study was a retroprospective study. A total of 212 prostate surgical specimens were included. Information provided in the requisition form regarding age, type of prostatic biopsy and clinical presentation, and histopathological diagnosis was taken into consideration and recorded. All specimens were fixed in 10% neutral buffered formalin and 5μ sections were stained with hematoxylin and eosin stain (H&E stain). Relevant clinical data including age, the presenting complaints, and S.PSA values were recorded. Data were collected and analyzed using simple statistical methods with Microsoft Excel 2016.

Results Out of 212 cases analyzed, 161 (76%) were transurethral resection of prostate (TURP) TUPR specimens, 38 (18%) were trucut needle biopsies, and 13 (6%) were open prostatectomy specimens. The youngest patient was 48 years old while the oldest patient was 90 years old with a mean of 71.7  ± 8.2 years. Of the total 212 surgical specimens, 174 (82%) cases were of benign prostatic hyperplasia (BHP), and 38 (18%) were prostatic adenocarcinoma (PAC). Also, 94 (44.3%) of BPH and carcinoma of the prostate cases were most common in the seventh decade of life (61-70 years). Difficulty in micturition was the most common presentation 82 (39%). A maximum number of the BPH cases 81 (46.5%) had the prostate-specific antigen range of 0 to 4 ng/mL. The highest value of serum PSA was noted among the PAC patients in the range of > 80 ng/mL. Out of 38 cases of prostatic adenocarcinoma, moderately differentiated (Gleason scores 7) was the most common core and was seen in 42.1% of the PAC cases.

Conclusion The present study showed that the most frequently encountered prostatic lesion was BHP, commonly seen in the age group of 61 to 70 years. The PAC was common among males of more than 60 years. Histopathological examination is the best diagnostic tool for PAC

Future Work

1. Immunohistochemistry (IHC) should be included in next research because it plays an important role in the diagnosis of prostatic lesions and helps to differentiate malignant glands from benign lesions.


2. It is critical in understanding the mechanisms of cancer development, progression, and metastasis, which might provide a new route for cancer detection and treatment. It would be useful to extend this investigation to the study of associated proteins in more detail, especially through proteomic analysis.




Publication History

Article published online:
19 December 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 Banerjee PP, Banerjee S, Brown TR, Zirkin BR. Androgen action in prostate function and disease. Am J Clin Exp Urol 2018; 6 (02) 62-77
  • 2 Untergasser G, Madersbacher S, Berger P. Benign prostatic hyperplasia: age-related tissue-remodeling. Exp Gerontol 2005; 40 (03) 121-128
  • 3 Thapa N, Shris S, Pokharel N, Tambay YG, Kher YR, Acharya S. Incidence of carcinoma prostate in transurethral resection specimen in a teaching hospital of Nepal. Journal of Lumbini Medical College. 2016; 4 (02) 77-79
  • 4 Te AE, Chughtai B. Benign prostatic hyperplasia. In: Kaplan SA, McVary KT, eds. Available at: Male Lower Urinary Tract Symptoms and Benign Prostatic Hyperplasia. 2014: 191-200 https://doi.org/10.1002/9781118437889.ch16ePDFPDF
  • 5 Bostwick DG, Cooner WH, Denis L, Jones GW, Scardino PT, Murphy GP. The association of benign prostatic hyperplasia and cancer of the prostate. Cancer 1992; 70 (1, Suppl) 291-301
  • 6 Evangalin JE, Aruthra P, Eswari V. Histomorphological spectrum of prostatic lesions and its correlation with prostate-specific antigen level. Journal of Medical Science and Clinical Research 2018; 6 (09) 448-453
  • 7 Deshpande NS, Dahe SV, Munemane AB, Dhokikar GD, Karle RR. Histopathological study of prostatic lesions in correlation with serum prostate specific antigen levels in elderly men. International Journal of Research in Medical Sciences 2020; 8 (09) 3304
  • 8 True LD. Surgical pathology examination of the prostate gland: practice survey by American Society of Clinical Pathologists. Am J Clin Pathol 1994; 102 (05) 572-579
  • 9 Gleason DF, Mellinger GT. Veterans Administration Cooperative Urological Research Group. Prediction of prognosis for prostatic adenocarcinoma by combined histological grading and clinical staging. J Urol 2017; 197 (2S): S134-S139
  • 10 Sajjanar AB, More SS. Prostatic lesions: a retrospective study of Turp specimen. International Journal of Clinical and Diagnostic Pathology 2019; 2 (01) 77-79 Available at: https://doi.org/10.33545/pathol.2019.v2.i1b.13
  • 11 Muthuvel E, Chander R V, Srinivasan C. Clinicopathological study of associated lesions in benign prostatic hyperplasia and prostatic adenocarcinoma in surgical biopsy specimens. Annals of Pathology and Laboratory Medicine 2018; 5 (02) A158-A164 DOI: 10.21276/apalm.1608.
  • 12 Josephine A. Clinicopathological study of prostatic biopsies. J Clin Diagn Res 2014; 8 (09) FC04-FC06 DOI: 10.7860/jcdr/2014/8591.4843.
  • 13 Gajjar H, Shah A, Parikh B, Shah J. Histopathological study of prostatic lesions. Indian Journal of Applied Basic Medical Sciences 2020; 22/B (35) DOI: 10.26860/ijabms.2020.22/b.35.20.
  • 14 Yadav M, Desai H, Goswami H. Study of various histopathological patterns in prostate biopsy. Int J Cur Res Rev 2017; 9 (21) 58-63
  • 15 Khan M, Khan AL, Khan S, Nawaz H. Benign prostatic hyperplasia: mode of presentation and postoperative outcome. J Pak Med Assoc 2005; 55 (01) 20-23
  • 16 Herawi M, Epstein JI. Specialized stromal tumors of the prostate: a clinicopathologic study of 50 cases. Am J Surg Pathol 2006; 30 (06) 694-704
  • 17 Issac A, Varughese A, Raghuveer C, SP Asha, K Preetha, Abdul. Majeed N, Rajan J. A Clinicopathological analysis of 120 cases of prostate biopsies and their correlation with prostate specific antigen levels. Annals of Pathology and Laboratory Medicine 2018; 5 (11) A882-A887 DOI: 10.21276/apalm.2237.
  • 18 Humphrey PA. Gleason grading and prognostic factors in carcinoma of the prostate. Mod Pathol 2004; 17 (03) 292-306
  • 19 Arshad H, Ahmad Z. Overview of benign and malignant prostatic disease in Pakistani patients: a clinical and histopathological perspective. Asian Pac J Cancer Prev 2013; 14 (05) 3005-3010
  • 20 Hameed S, Malik A, Bilal S, Dogar SR, Aslam A. Pattern of prostatic disease: a histopathological survey. Prof Med J 2010; 17 (04) 573-577