Prostatic FNAC, Evaluation as a Diagnostic Tool and Correlation with Serum Prostate Specific Antigen.

Corresponding Author:
Dr. Alka Upreti,
House No. 8/3, Sector 10,
Indira Nagar, Lucknow-226016,
Uttar Pradesh, India.
E-mail: alkaupreti@gmail.com

ABSTRACT

BACKGROUND

For proper diagnosis of prostatic diseases there are many investigations starting from per rectal examination, transurethral cystoscopy, fine needle aspiration cytology, six quadrants core biopsy, serum enzymes estimation like prostate specific antigen and acid phosphatase and ultrasound examination. Out of these, only FNAC and core biopsy prostatic tissue can be examined for final diagnosis. For examination of core biopsy, a complete histopathology set up is required with a trained technician but FNAC is a simple outpatient procedure where no trained technician is required. It requires only few reagents and a qualified pathologist. Since geriatric population is increasing day by day and prostatic adenocarcinoma is now second commonest malignancy in males, diagnosis is very important to reduce morbidity and mortality caused by this disease.

METHODS

The study group consisted of 40 patients who presented with symptoms of obstructive uropathy and on DRE (Direct Rectal Examination) had prostatic enlargement. FNAC was done with Franzen canula using non aspiration technique and serum PSA was done by ELISA method.

RESULTS

All the patients in our study were above 50 yrs. of age. Out of 40 cases 5 cases were of prostatitis they were mostly bellow 70 yrs. of age. 10 BHP and 25 prostatic adenocarcinomas. The carcinoma cases were almost all above the age of 70 yrs. BHP and carcinoma cases were correlated with histopathology whereas prostatitis cases were followed up clinically. Our sensitivity for benign lesion was 100% and for malignancy 92%. The serum PSA was up to 6.8 ng/ml in benign conditions and above 10 ng/ml in adenocarcinomas.

CONCLUSIONS

FNAC prostate is very sensitive and reliable diagnostic tool. It is painless OPD procedure without complications and can be done easily in any small setup, where facility of histopathology is not available. The procedure is well accepted by geriatric population due to its simplicity and being a painless OPD procedure. Serum PSA cannot be used as screening test for prostatic carcinoma but can be used for prognostic indicator.

KEY WORDS

Prostate, Fine Needle Aspiration Cytology, BHP, Prostatic Adenocarcinoma, Prostatitis, PSA