A Cross-Sectional Study of prevalence of Prostate lesions and inter-Observer Variability in Histopathological Reporting
Archives of Men's Health,
Vol. 5 No. 1 (2021),
6 January 2021
,
Page e18
https://doi.org/10.22037/mhj.v5i1.34430
Abstract
Introduction: To report the prevalence of various prostate lesions in the general population through cadaver prostates and to determine the interobserver variability for reporting high-grade lesions of the prostate. Materials and Methods: The cross-sectional study was carried out on 110 autopsy specimens of healthy prostate with deceased age over 40 years. The specimens were grossed, sectioned, stained and reported independently by the primary investigator resident and the senior professor. The lesions were categorized into prostatitis, benign prostate hypertrophy (BPH), prostate intraepithelial neoplasia (PIN) further graded as low grade (LGPIN) and high grade (HGPIN) and prostate cancer (PCa). Inter-rater kappa agreement was used to find the strength of agreement between the pathologists. Results: Among 110 prostate specimens, only 8(7.27%) cases had normal prostate with 72 (65.4%) having BPH and 12(10.9%) cases having prostatitis. There were 17 cases of PIN with 11 cases of HGPIN and 6 cases of LGPIN. Malignancy was seen in only a single case (95% Confidence Interval: 0% - 2.71%). The primary resident missed 4 cases of HGPIN and 2 cases of LGPIN. Interobserver agreement between the resident and senior pathologist was fair (Kappa 0.282, p value=0.335). Conclusion: In conclusion, prostate lesions remain latent and show high prevalence in general population without causing any symptoms. The study depicts a high interobserver variability of reporting the high-grade lesions of prostate since they cause a diagnostic dilemma with PCa. The consultation with uropathologists and use of molecular markers must be included in the diagnostic panel while reaching a final diagnosis.
- Neoplasms; Pathology; Prostate
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References
Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians. 2018;68(6):394-424.
Ferlay J, Ervik M, Lam F, Colombet M, Mery L, Piñeros M, et al. Global Cancer Observatory: Cancer Today. Lyon, France: International Agency for Research on Cancer. Retrieved February 21, 2019. 2018.
Bray F, Piñeros M. Cancer patterns, trends and projections in Latin America and the Caribbean: a global context. salud pública de méxico. 2016;58(2):104-17.
Kovács G, Hoskin P. Interstitial Prostate Brachytherapy. Εκδόσεις Springer, Verlag Berlin Heidelberg. 2013:2-12.
Barr RG, Cosgrove D, Brock M, Cantisani V, Correas JM, Postema AW, et al. WFUMB guidelines and recommendations on the clinical use of ultrasound elastography: part 5. Prostate. Ultrasound in medicine & biology. 2017;43(1):27-48.
Knowledge B, Menu M. Read BJUI.
Cotran RS, Kumar V, Collins T. Robbins pathologic basis of disease 6th ed. Philadelphia, Pa: Saunders. 1999:1019-20.
Vilanova JC, Catalá V, Algaba F, Laucirica O. Atlas of Multiparametric Prostate MRI.
Barentsz JO, Richenberg J, Clements R, Choyke P, Verma S, Villeirs G, et al. ESUR prostate MR guidelines 2012. European radiology. 2012;22(4):746-57.
Junker D, De Zordo T, Quentin M, Ladurner M, Bektic J, Horniger W, et al. Real-time elastography of the prostate. BioMed research international. 2014;2014.
Ahmed HU, Kirkham A, Arya M, Illing R, Freeman A, Allen C, et al. Is it time to consider a role for MRI before prostate biopsy? Nature reviews Clinical oncology. 2009;6(4):197-206.
Junker D, Schäfer G, Kobel C, Kremser C, Bektic J, Jaschke W, et al. Comparison of real-time elastography and multiparametric MRI for prostate cancer detection: a whole-mount step-section analysis. American journal of roentgenology. 2014;202(3):W263-W9.
Aldaoud N, Hallak A, Abdo N, Al Bashir S, Marji N, Graboski-Bauer A. Interobserver Variability in the Diagnosis of High-Grade Prostatic Intraepithelial Neoplasia in a Tertiary Hospital in Northern Jordan. Clinical Pathology. 2020;13:2632010X19898472.
Lee D, Lee C, Kwon T, You D, Jeong IG, Hong JH, et al. Clinical features and prognosis of prostate cancer with high-grade prostatic intraepithelial neoplasia. Korean journal of urology. 2015;56(8):565.
Mettlin CJ, Murphy GP. Why is the prostate cancer death rate declining in the United States? : Wiley Online Library; 1998.
Srigley JR, Humphrey PA, Amin MB, Chang SS, Egevad L, Epstein JI, et al. Protocol for the examination of specimens from patients with carcinoma of the prostate gland. Archives of pathology & laboratory medicine. 2009;133(10):1568-76.
Bostwick DG, Cheng L. Precursors of prostate cancer. Histopathology. 2012;60(1):4-27.
Epstein JI. Precursor lesions to prostatic adenocarcinoma. Virchows Archiv. 2009;454(1):1-16.
Kronz JD, Milord R, Wilentz R, Weir EG, Schreiner SR, Epstein JI. Lesions missed on prostate biopsies in cases sent in for consultation. The Prostate. 2003;54(4):310-4.
Tosoian JJ, Mamawala M, Epstein JI, Landis P, Wolf S, Trock BJ, et al. Intermediate and longer-term outcomes from a prospective active-surveillance program for favorable-risk prostate cancer. Journal of Clinical Oncology. 2015;33(30):3379.
Bostwick DG, Qian J. High-grade prostatic intraepithelial neoplasia. Modern pathology. 2004;17(3):360-79.
Davidson D, Bostwick DG, Qian J, Wollan PC, Oesterling JE, Rudders RA, et al. Prostatic intraepithelial neoplasia is risk factor for adenocarcinoma: predictive accuracy in needle biopsies. The Journal of urology. 1995;154(4):1295-9.
De Silva M, Fernando MS, Abeygunasekera A, SA SG. Prevalence of prostatic intraepithelial (PIN) in surgical resections. Indian journal of cancer. 1998;35(4):137-41.
McNeal JE, Bostwick DG. Intraductal dysplasia: a premalignant lesion of the prostate. Human pathology. 1986;17(1):64-71.
Montironi R, Thompson D, Bartels P. Premalignant lesions of the prostate. Recent advances in histopathology. 1999;18:147-72.
Bostwick DG, Qian J, Frankel K. The incidence of high grade prostatic intraepithelial neoplasia in needle biopsies. The Journal of urology. 1995;154(5):1791-4.
Montironi R, Bostwick DG, Bonkhoff H, Cockett AT, Helpap B, Troncoso P, et al. Workgroup 1: Origins of prostate cancer. Cancer: Interdisciplinary International Journal of the American Cancer Society. 1996;78(2):362-5.
Jones EC, Young RH. The Differential Diagnosis of Prostatic Carcinoma: Its Distinction from Premalignant and Pseudocarcinomatous Lesions of the Prostate Gland. American Journal of Clinical Pathology. 1994;101(1):48-64.
Bostwick DG, Amin MB, Dundore P, Marsh W, Schultz DS. Architectural patterns of high-grade prostatic intraepithelial neoplasia. Human pathology. 1993;24(3):298-310.
Brawer MK. Prostatic intraepithelial neoplasia: an overview. Reviews in urology. 2005;7(Suppl 3):S11.
Drago J. Introductory remarks and workshop summary. Urology. 1989;34:2-3.
Ayala AG, Ro JY. Prostatic intraepithelial neoplasia: recent advances. Archives of pathology & laboratory medicine. 2007;131(8):1257-66.
Bostwick DG, Brawer MK. Prostatic intra‐epithelial neoplasia and early invasion in prostate cancer. Cancer. 1987;59(4):788-94.
Haggman MJ, Macoska JA, Wojno KJ, Oesterling JE. The relationship between prostatic intraepithelial neoplasia and prostate cancer: critical issues. The Journal of urology. 1997;158(1):12-22.
Tan PH, Tan HW, Tan Y, Lim CN, Cheng C, Epstein JI. Is high-grade prostatic intraepithelial neoplasia on needle biopsy different in an Asian population: a clinicopathologic study performed in Singapore. Urology. 2006;68(4):800-3.
Cosi I, Pellecchia A, De Lorenzo E, Torre E, Sica M, Nesi G, et al. ETV4 promotes late development of prostatic intraepithelial neoplasia and cell proliferation through direct and p53-mediated downregulation of p21. Journal of hematology & oncology. 2020;13(1):1-16.
Leite KR. Why do we keep reporting high-grade prostatic intraepithelial neoplasia (HGPIN)? International braz j urol. 2016;42(2):180-2.
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