Background
Prostate cancer can be detected incidentally in patients undergoing transurethral resection of the prostate for benign prostatic hyperplasia. Therefore, it is very important that the transurethral resection of the prostate specimen is evaluated carefully for accurate grading and staging. The aim of this study was to investigate the frequency of incidental prostate cancer and its relationship with clinicopathological findings.
Methods
The study included a total of 900 patients, who underwent transurethral resection of the prostate for benign prostatic hyperplasia treatment between June 2010 and June 2020. Patient age, prostate-specific antigen (PSA) levels and resected prostate weight were assessed, and the tumor stage, Gleason grade group, lymphovascular and perineural invasion status were also evaluated in the incidental prostate cancer group. The association between these parameters and prostate cancer detection was analyzed.
Results
Incidental detection of prostate cancer was determined at the rate of 13.3%. The incidental prostate cancer group had a significantly higher mean age and PSA levels compared to the benign prostatic hyperplasia group. The weight of the resected specimen had no impact on the incidence of incidental prostate cancer. Of the total 120 incidental prostate cancer cases, 59 (49.2%) were stage T1a and 61 (50.8%) were stage T1b. No significant difference was determined between the T1 stages and age distribution, but a statistically significant difference was determined in the other clinicopathological parameters.
Conclusions
The results of this study demonstrated that the incidence of incidental prostate cancer detection was related to age and PSA levels and increased, especially in those aged ≥ 60 years and/or PSA level ≥ 4 ng/mL. To avoid overlooking incidental prostate cancer in these patients, it can be recommended that material is sufficiently sampled and carefully evaluated, and when necessary, all resected specimens are examined. Although no significant correlation was determined between specimen weight and the incidence of incidental prostate cancer, as a significant difference was determined in T1 stages, this suggests that the amount of material evaluated could change the sub-stage.
Amaç: Kronik lenfositik tiroidit/Hashimoto tiroidit (KLT/HT) tanılı hastalarının, tiroid lezyonlarını değerlendirmek amacıyla ince iğne aspirasyon ile elde edilen sitoloji materyallerine uygulanan sıvı bazlı sitoloji yönteminin tanı güçlüğü yaratan sitomorfolojik özellikleri saptamak. Gereç ve Yöntemler: Retrospektif olarak bu çalışmaya 2014 ve Mayıs 2018 yılları arasında şüpheli nodül veya kozmetik amaçlı cerrahi operasyon geçiren 70 KLT/HT tanılı hastanın nodülüne ait tanısal ince iğne aspirasyon biyopsisi dahil edildi. Olguların histolojik ve sitolojik tanıları yeniden gözden geçirildi. Sıvı bazlı preparatlarındaki sitomorfolojik özellikler incelendi ve histolojik tanılarıyla karşılaştırıldı. Bulgular: Olgularımızın %52'si benign, %38'i ara sitolojik kategori (önemi belirsiz atipi/önemi belirsiz foliküler lezyon, foliküler neoplazi/foliküler neoplazi şüphesi ve malignite şüpheli) ve %10 malign sitoloji olarak raporlandı. Reaktif lenfoid hücre olguların %84'ünde az miktarda izlenirken kolloid ise olguların %50'inde saptandı. Papiller karsinom tanılı olguların %69'unda intranükleer psödoinklüzyon ve tamamında nükleer kontur düzensizliği mevcuttu. Sonuç: Sıvı bazlı sitoloji yöntemi uygulanan sitolojik materyallerde, kolloid ve inflamatuvar hücrelerinin azalması olguların ara sitolojik kategori olarak yorumlanmasına ve gereksiz cerrahiye neden olurken temiz zemin sayesinde nükleer detayı daha rahat değerlendirmemizi sağlayarak KLT/ HT'li hastalarda malign lezyonların tanılabilirliğini artırdığını düşünmekteyiz.
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