Comparison of Old Gleason Score with Modified Gleason Score and Correlation of Needle Biopsy of Prostate with PSA

ABSTRACT

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 prostateprostatitis, 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.