Study of transrectal ultrasound guided biopsies of prostate in correlation with serum prostate specific antigen level

Prostatic carcinoma has been increasing in India in the recent past. It is routine clinical practice to test for serum PSA followed by prostatic biopsy in all the suspected cases of prostatic carcinoma.

To study the histopathology of prostate biopsies and to correlate the serum PSA levels with TRUS guided biopsy findings of carcinoma and BPH.

This was a retrospective study carried out in the department of Pathology at Kamineni Academy of Medical Sciences and Research Centre, Hyderabad, over a period of three years. A total of 128 patients underwent TRUS guided prostate biopsy out of which only 61 cases were considered for the study as they had also undergone simultaneous prebiopsy serum PSA testing. The biopsy findings of carcinoma and BPH were correlated with serum PSA level.

The mean age for carcinoma and BPH was 66.5 and 64.6 years respectively. A total of 17 (27.8%) cases had serum PSA in the grey zone of 4–10 ng/ml. Among BPH cases, 33.3% showed an elevated serum PSA in the 20.1–100 ng/ml range. A Gleason score of 3+4 was the most common score and was seen in 63.3% cases. The mean PSA for carcinoma was

48.7 ng/ml. High serum PSA in the range of 20.1–100 ng/ml range was seen in 46.6% cases of carcinoma. Also 16.6% (5 out of 30) cases of carcinoma showed PSA in the grey zone.

Serum PSA levels more than 20 ng/ml point towards carcinoma many cases of BPH can show values in the grey zone area that can cause unnecessary anxiety in patients. TRUS biopsies are useful for diagnosing prostatic adenocarcinoma.