Evaluation of Spectrum of Prostatic Biopsies Using the Revised Gleason Grading System and Prostate Specific Antigen Assay

Abstract

Introduction: The incidence of prostatic adenocarcinoma is rising worldwide, and a stratified uniform diagnostic approach is required to develop a treatment protocol for patients. This study was undertaken in a medical college in eastern Uttar Pradesh with the aim to estimate the burden of prostatic lesions in the area and to classify them according to the revised Gleason’s grading system.Materials and Methods: This was a descriptive type of observational study of three years duration were 238 cases of prostatic biopsies in Pathology department of Heritage institute of medical sciences, Varanasi. The lesions were classified on histopathology according to the revised Gleason’s grading system and association of prostatic lesions with serum Prostate Specific Antigen was also evaluated. The results were tabulated as pie chart and percentage and comparison was described. Results: The mean age of patients with benign prostatic hyperplasia was 56.74 years while it progressed to 75.5 years in patients with prostatic adenocarcinomas. The most common histopathological diagnosis was benign prostatic hyperplasia followed by BPH with chronic prostatitis. The most common Gleasons score in adenocarcinoma was 7. Serum PSA was found to be significantly raised in patients with prostatic adenocarcinomas in comparison to benign prostatic lesions.Conclusion: Benign prostatic hyperplasia is the most common prostatic lesion among adult males in eastern Uttar Pradesh. Implementation and awareness of Revised Gleason’s grading system will help in proper stratification and uniformity needed for better communication among pathologist and treating clinicians required for adequate treatment approach.