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Introduction: The prostate gland is a secondary sex, exocrineorgan that is an integral part of the human male reproductivesystem. There are three main diseases of the prostate:prostatitis, benign prostatic hyperplasia, and prostate cancer.The new grading system for prostate cancer has obviousbenefits that is: it has more accurate grade stratification thanthe current Gleason system. PSA is serine protease producedby ductal and acinar epithelial cells of normal, hyperplastic,and malignant tissue of the prostate. To study morphologicfeatures of the benign and malignant lesions of prostate,histopathological correlation of benign and malignant lesionsof prostate with serum PSA level, compare new Gleasongrading system with old Gleason grading system.Material and Methods: All the needle biopsies and TURPspecimens submitted to the histopathology laboratory,Department of Pathology, Government medical college, Kotaduring the period from January 2014 to june 2016. We receivedtotal 445 prostate biopsies and TURP specimen from January2014 to June 2016 at our department of pathology, Govt.Medical College, Kota and were examined with haematoxylinand eosin and compare new gleason grading system with oldgleason grading system.Results: On histopathological examination of total 441cases, the majority of cases 323 (73.24%) were benign, 109(24.72%) cases were malignant and 9 (2.04%) cases were pureinflammatory lesions.Conclusion: We observed continuous and significant risingtrend of prostate malignancy from year 2014 to june 2016.Prostatic carcinoma is the malignant neoplasm of aging menmaximum number of prostatic carcinoma were found in agegroup 61-70 yr. Majority (14 cases; 12.84%) of carcinomaprostate cases were found to be associated with PSA level>100.0 ng/ml. In present study majority of cases had Gleasonscore 6 (48%) followed by Gleason score 7 (29%), Gleasonscore 8 (13%), Gleason score 5 (4%), Gleason score 9 (3%)and least one cases in Gleason score 2, 4 and PIN.
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Objective To analysis the modified Gleason scoring system for predicting the prognosis after radical prostatectomy.Methods A total of 242 patients who received radical prostatectomy from April,2006 to October 2011 were recruited.The patients who lost follow-up or had adjuvant radiation or hormonal therapy or had visceral or bone metastasis were excluded,the remaining 168 patients were evaluated in the present study.The patients' age ranged from 53 to 85 years old (mean age 69 years old).The mean PSA level was 13.31ng/ml (ranging from 4.59 to 36.12 ng/ml).According to the traditional Gleason scoring system,there were 50 patients in Gleason ≤ 6 group,86 patients in Gleason 7 group and 32 patients in Gleason≥8 group.Patients were divided in five groups according to the modified Gleason scoring system.There were 50 patients in Gleason ≤6 group,67 in Gleason 3 + 4 group,19 in Gleason 4 + 3 group,15 in Gleason 8 group and 17 in Gleason 9-10 group.The biochemical-free-survival curve was drawn by Kaplan-Meier method and the multivariate Cox regression models were used to evaluate the clinical and pathological variables for the development of biochemical recurrence.ROC curve analysis was used to determine the predicted value for 5-year BCR of modified and traditional Gleason scoring.Results Significant differences were noted between the modified Gleason scoring groups and traditional Gleason scoring groups in PSA value (P =0.005),pathological stage (P =0.002),extraprostatic extension (P =0.003),seminal vesicle invasion (P =0.004),lymph node involvement (P =0.049) and positive surgical margin (P =0.006).With a median follow-up of 68 months(ranging from 7 to 98 months),5-year BFS rates for men with Gleason grade ≤6,3 + 4,4 + 3,8 and 9-10 tumours on RP pathology were 84.0％ (42/50),76.1％ (51/67),57.9％(11/19),40.0％ (9/15),29.4％ (5/17),respectively.On multivariate analysis,the HR value of Gleason 3 + 4 group and Gleason 4 + 3 group were 1.736 and 2.075 (P ＜ 0.05).The area under the curve in modified and traditional Gleason scoring were 0.698 (95％ CI 0.609-0.788) and 0.674 (95％ CI O.584-0.764),respectively.Conclusions The modified Gleason scoring system is related to the prostate cancer grade and its survival rate.Therefore,it can predict prognosis accurately in patients with prostate cancer.It can potential to reduce overtreatment in patients with Gleason 3 +4 prostate cancer.