Histopathology Study of Prostatic Lesions and Its Correlation with Serum Prostate Specific Antigen

Abstract

Prostatic lesions encompass a range of pathological entities, from benign hyperplasia to malignancy, predominantly affecting elderly men. Serum prostate-specific antigen (PSA) is widely used as a biomarker in the diagnosis and management of prostatic diseases. Correlation of serum PSA levels with histopathological findings is essential for accurate clinical interpretation. Aim: To study the histopathological spectrum of prostatic lesions and correlate them with serum PSA levels in elderly men. Methods: A cross-sectional observational study was conducted on 126 elderly men presenting with prostatic symptoms or elevated PSA. Prostate tissue obtained by biopsy, TURP or surgical specimens was examined histopathologically and classified into benign, malignant, or inflammatory lesions. Concurrent serum PSA levels were measured. Statistical analysis evaluated the correlation between PSA levels and histopathological diagnosis. Results: Benign prostatic hyperplasia constituted 69.05% of cases, prostatic carcinoma 25.40%, and prostatitis/inflammatory lesions 5.55%. Mean serum PSA levels were significantly higher in malignant lesions (56.8 ± 35.4 ng/mL) compared to benign lesions (7.4 ± 5.9 ng/mL) and inflammatory lesions (18.3 ± 12.6 ng/mL) (p < 0.001). A positive correlation was observed between PSA levels and Gleason grade in carcinoma cases (p = 0.002). Conclusion: Serum PSA levels correlate significantly with histopathological findings in prostatic lesions among elderly men. Elevated PSA suggests malignancy, while lower levels are associated with benign pathology. Histopathological evaluation remains the definitive diagnostic tool, and combined use of PSA measurement enhances diagnostic accuracy and patient management.