Prostate carcinoma: correlation of histopathology with serum prostate specific antigen

Abstract

Prostate Specific Antigen (PSA) is the first line test in screening of prostate cancer. The increase in PSA depends on differentiation of tumour cells. Gleason grading is one of the most powerful predictors of biological behaviour and influential factors used to determine treatment. PSA, when combined with Gleason score and clinical stage, improves the prediction of pathological stage for prostate carcinoma. Aims of this study were to study the histopathological features and Gleason grading in Prostatic Carcinoma and to correlate pretreatment PSA levels with Gleason grade. The study was undertaken in a tertiary care hospital over a period of two years.Fifty one cases of prostatic carcinoma were studied. Grading done by Gleason grading system, was correlated with serum PSA levels. Software statistical package for social sciences (SPSS), version 16 was used. P value < 0.05 was considered significant. Patients were aged predominantly between 60 to 70 yrs. Majority (66.7%) had poorly differentiated adenocarcinoma. 84.3% had high values of PSA (>10ng/ml). 5.9 % had PSA value in normal range (< 4 ng/ml). Though there was a comparative increase in PSA level with increase in Gleason grade, it was not statistically significant (‘p’ value = 0.75). To conclude, a proportion of tumours with Gleason score 8-10 are so poorly differentiated that they produce relatively little PSA. Refinement in estimation and interpretation of PSA values may be considered to improve the sensitivity and specificity of PSA. Gleason grading is a better predictor of biological behaviour of prostate cancer.