Comparison of radical prostatectomy and tru-cut biopsy materials of patients with diagnosed of prostate acinar adenocarcinoma in respect to histological grade, high grade prostatic intraepithelial neoplasia, basal cell hyperplasia and granulomatous prostatitis

Comparison of radical prostatectomy and tru-cut biopsy materials of patients with diagnosed of prostate acinar adenocarcinoma in respect to histological grade, high grade prostatic intraepithelial neoplasia, basal cell hyperplasia and granulomatous prostatitis. AIM: Tru-cut needle biopsy (TCIB) is the main diagnosis method, and radical prostatectomy (RP) is the main treatment method of prostate cancer. Mistakes that may occur in diagnosis and misdirection of the patient to the wrong treatment are the handicaps of TCİB. In addition to the importance of histological grade in guiding the treatment in PCA, high-grade prostatic intra-epithelial neoplasia (HPIN) is a precursor lesion of cancer, and basal cell hyperplasia (BCH) is important in the histopathological evaluation of PCA materials, especially because it can be confused with PCA in TCİB. Diagnostic concordance between TCİB and RP is important to determine the correct treatment modality. In this study, we aimed to reveal the concordance of neoplastic and some non-neoplastic diagnoses between TCİB and RP materials, and the role of TCİB in guiding the diagnosis and treatment of PCA in cases diagnosed with PCA as a result of TCİB and undergone RP. MATERIALS AND METHODS: In our clinic, 93 patients who were diagnosed with PCA and had RP between January 2018 and October 2022 were included in the study. Hematoxylin-Eosin (H&E) stained preparations prepared after tissue follow-up were evaluated under the light microscope. RESULTS: In terms of Grade Group (GG) evaluation, 61.3% of the patients who underwent RP were found to be compatible with the diagnoses of TCİB. While this concordance was highest in patients diagnosed with GG5 in TCİB, it was the lowest with 33% in GG3 and 16.7% in GG4. In our study, the incidence of HPIN was found to be 24.7% in TCİB and 79.5% in RP materials. In RP materials, the BHH rate was 48.3%. Nonspecific granulomatous prostatitis (NGP) was detected at a rate of 1.07% in TCİB and 6.4% in RP materials. CONCLUSION: In our study, 39.4% of the cases had an incompatibility between TCİB and RP materials. Therefore, it should not be ignored that there may be higher grade tumor foci (total upgrade 34% in our study), especially in GG1 cases, in areas that could not be sampled by TCİB. The prevalence of HPIN in TCİB materials can be considered as an indicator of an increased risk of PCA in the case. Despite the risk of confusion with PCA in TCİB, we did not find any evidence of a relationship between BHH and PCA. TCİB seems to play a role in the etiology of GP, which is more common in RP. Keywords: Needle biopsy, radical prostatectomy, prostate cancer