STUDY OF LESIONS OF PROSTATE AFTER SURGERY AND ITS CORRELATION WITH PSA LEVEL AND EXPRESSION OF P504S IHC MARKER IN MALIGNANT LESIONS OF PROSTATE

Authors: DEEPALI GUPTA, DEEPAK MITTAL, Geetika Agarwal, HEMANT KUMAR, DIVYA PURSNANI, Tanmeet Kaur, ASMITA ASMITA

DOI: 10.18231/j.ijpo.10788.1620688092

Keywords: Prostate lesions, PSA levels, P504S, Immunohistochemistry, Prostate cancer, Histopathology

Abstract: Background Prostate lesions encompass a spectrum of benign and malignant pathologies, with prostate-specific antigen (PSA) serving as a key biomarker in their evaluation. Immunohistochemical (IHC) markers, such as α-methylacyl-CoA racemase (P504S), have emerged as adjuncts in distinguishing malignancies. This study aims to analyse post-surgical prostate lesions, correlate histopathological findings with PSA levels, and assess the expression of P504S in malignant cases. Methods This hospital-based observational study was conducted in 150 prostate specimens which were obtained post-surgery. After the thorough analysis. Histopathological classification was performed and PSA levels were analysed in relation to lesion type. IHC staining for P504S was conducted in malignant cases to determine its diagnostic utility. Statistical analysis was applied to assess correlations between PSA levels, histological diagnosis, and P504S expression. Results: We analysed a total of 150 cases, with the highest proportion (48.67%) in the 60–70 years age group and a mean age of 67.40 ± 8.69 years. Non-neoplastic lesions were predominant (94%), while neoplastic cases accounted for 6%. Benign lesions were most common in the 60–70 years group, whereas malignancy was more frequent in individuals over 80 years (44.44%). Retention of urine (30%) was the most common symptom. Histopathological analysis showed benign prostatic hyperplasia (41.33%) as the most frequent diagnosis, followed by chronic nonspecific prostatitis (25.33%) and adenocarcinoma (6%). PSA levels above 20 ng/mL were predominantly associated with malignancy. Higher Gleason scores (9 and 8) were common, indicating aggressive tumors. A significant correlation was observed between age, PSA levels, and Gleason’s score (p < 0.0001). Conclusion: Our study concludes that, histopathological evaluation remains the gold standard for diagnosing prostate lesions, while PSA serves as a useful but non-specific biomarker. P504S IHC staining enhances the diagnostic accuracy for malignancy. The combination of PSA levels with histopathological and IHC findings improves the stratification of prostate lesions, easing early and accurate diagnosis.