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Original Articles
- Clinicopathologic Features of Prostatic Adenocarcinoma: A Study of 58 Radical Prostatectomy Specimens.
- Tae Jin Lee, Mi Sun Choe, Choung Soo Kim, Jae Y Ro
- Korean J Pathol. 1999;33(11):1067-1075.
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Abstract
PDF - Prostatic carcinoma is the most commonly diagnosed cancer in the United States in men. Prostatic carcinoma in Korean men is uncommon and accounts for less than 1% of total cancer: however, the incidence of prostatic carcinoma is continuously increasing. Several clinicopathologic parameters including stage, Gleason score, and serum PSA level have been widely accepted as well established prognostic factors. To study the clinicopathologic features of prostatic carcinoma in Korean men, 58 cases of prostatic carcinoma, which were diagnosed on radical prostatectony specimens at Asan Medical Center from Jan. 1993 to June 1998 (1993; 3 cases, 1994; 3, 1995; 6, 1996; 12, 1997; 24, 1998; 10), were evaluated. The prostatic carcinomas were divided into three groups according to Gleason score. Tumors with Gleason score 6 or lower, 7, and 8 to 10 were categorized as low-grade, intermediate-grade and high-grade tumor, respectively. The overall mean age of the patients was 62.6 years (range, 4 6~76 years); mean age was 65.4, 62.8 and 61.1 in low, intermediate and high-grade tumor, respectively (p>0.05). The overall mean serum PSA level was 38.6 ng/ml (range, 0.3~276.0 ng/ml); mean serum PSA level was 17.0, 29.0 and 60.9 ng/ml in low, intermediate and high-grade tumor, respectively (p=0.002). The mean T stage was 2.3, 2.4 and 3.1 in low, intermediate and high-grade tumor (p=0.001). The percentage of positive resection margin was 33.3, 50.0 and 91.0 % in low, intermediate and high-grade tumor (p=0.001). The overall presence of prostatic intraepithelial neoplasia (PIN) was 79.3 %; percentage of the presence of PIN was 100, 79.2 and 68.2 % in low, intermediate and high-grade tumor (p>0.05). As reported in the literature, our results indicated that Gleason score was a good predictor of stage and prognosis. The higher Gleason score, the more cases were with positive surgical margins, advanced pathologic stage, and high serum PSA level (p<0.05).
- Prostatic Intraepithelial Neoplasia in Transurethral Resection Specimens On serum PSA and histologic findings.
- Joon Mee Kim, Soo Kee Min, Young Chae Chu, Tae Sook Hwang, Young Bae Kim, Jee Young Han, Tae Sook Kim, Hye Seung Han
- Korean J Pathol. 2000;34(5):349-357.
- 1,530 View
- 11 Download
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Abstract
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- Prostatic intraepithelial neoplasia (PIN), which is divided into low and high grade, has different clinicopathologic significance. We reviewed 158 prostatic tissues, which consisted of 144 cases of nodular hyperplasias and 14 cases of adenocarcinomas, to evaluate incidence of PIN, its histologic finding, and its clinical significance. Ten cases of PIN, 4 low grade and 6 high grade, were found. Four cases of low grade PIN (LPIN) and five cases of high grade PIN (HPIN) were associated with nodular hyperplasia. Only one case of HPIN occurred in carcinoma. The constant histologic findings of LPIN were nuclear stratification and nucleomegaly. The most prominent characteristics of HPIN were hyperchromasia and prominent nucleoli. Anisonucleosis was not so helpful for differential diagnosis between LPIN and HPIN. Basal layer disruption was present in one case of high grade PIN associated with adenocarcinoma, and important for the differentiatial diagnosis of cribriform HPIN from the cribriform adenocarcinoma. There was no significant difference in age incidence between the two groups with the mean age of 70.9 years in nodular hyperplasia and 69.4 years in adenocarcinoma. Serum PSA level was significantly different between the two group with the mean PSA value of 11.03 ng/ml in nodular hyperplasia and that of 73.76 ng/ml in carcinoma (p=0.000). However, PSA values between "nodular hyperplasia only" group and "PIN associated nodular hyperplasia" group were not significantly different. PIN association changed neither age distribution nor serum PSA level. During the follow up period, no adenocacinoma has occurred in the cases having PIN although serum PSA level has elevated in some cases. One case of adenocarcinoma associated with HPIN developed in the nodular hyperplasia patient. Although PIN did not increase the possibility of subsequent prostatic adenocarcinoma in transurethral resection specimens, it could not be excluded that PIN was a precursor of prostatic adenocarcinoma.
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