Demographic, Biochemical and Histopathological Features of Prostate Adenocarcinoma at Chris Hani Baragwanath Academic Hospital, South Africa

Abstract

Background One of the main causes of cancer related deaths in men is prostate cancer (PCa) and PCa is also the commonest cancer diagnosed in South African men. There is a lack of research pertaining to PCa in this country. The aim of this study is to describe the demographic, biochemical and histopathological features of prostate carcinoma diagnosed at the Chris Hani Baragwanath Academic Hospital Histopathology Laboratory. Methods We embarked on an observational retrospective study collating information from the histopathology reports of all prostate needle core biopsies submitted to the laboratory within a 13-month period (from 1 January 2018 to 31 January 2019). The age, race (where available), serum prostate specific antigen (PSA) level, previous biopsy results, number of cores, diagnostic category, tumour grade, tumour volume, presence or absence of perineural invasion, presence or absence of lymphovascular space invasion, Gleason grade, presence of metastasis and the results of p63 immunohistochemistry were captured from the relevant reports. Results A total of 784 cases were reviewed. Of these, 317 cases (40.4%) were assigned a benign diagnosis and 467 (59.6%) were assigned a malignant diagnosis. The mean age of patients diagnosed with malignancy on core biopsy was 66.65 years, which was significantly older than the mean age of 65.19 years in patients with benign diagnoses (p=0.014). Data on race was available for only 289 patients (36.86%) and 36.2% of tumour cases were noted in African men. The median PSA for the cohort was 15.2ug/L and PSA levels were significantly higher in patients with malignancy (median 23.35ug/L) than in patients with benign diagnoses (median 9.60ug/L), p=<0.005. In addition, 60% of patients with a raised PSA (defined as more than 4ug/L) were diagnosed with carcinoma on biopsy. A significant v difference in PSA levels across Grade groups was noted (p=<0.005) and PSA levels in patients with perineural invasion were significantly higher than for those without perineural invasion (p=<0.005). A strong positive correlation was demonstrated between the PSA level and tumour volume (p=<0.005). The median tumour volume was 40%. Conclusion This study showed similar findings to other published studies on PCa within the South African population. It has been shown that South African patients present later than those in more western parts of the world and this may explain why in our cohort most cases were diagnosed as PCa, patients were noted to have higher PSA levels as well as a median tumour volume of 40%