Transrectal fine needle aspiration biopsy of the prostate combining cytomorphologic, DNA ploidy status and cell cycle distribution studies

Fine needle aspiration (FNA) cytology of the prostate is becoming a common diagnostic procedure, and DNA flow cytometry (FCM) data have been shown to correlate with the pattern of evolution of prostatic carcinoma, thus emphasizing the importance of assessing both parameters together. The aim of the present paper is to analyze the presence of DNA aneuploidy, cell cycle distribution and their relationship with the cytologic grade in transrectal fine needle aspiration prostate biopsies from 78 consecutive patients. Herein we studied the DNA ploidy status, the cell cycle distribution and their relationship with cytologic grade in transrectal FNA biopsies of the prostate from 78 consecutive patients -47 benign hyperplasias and 31 carcinomas- as analyzed by a reproducible FCM method for single cell suspension preparations, data acquisition and analysis. The presence of DNA aneuploidy was detected in 39% of the carcinomas and it was found to be a specific marker for prostatic carcinoma since all benign hyperplasia cases were diploid. Moreover, the incidence of DNA aneuploidy increased progressively from well-differentiated to moderately-differentiated and poorly-differentiated carcinomas (p = 0.005). Regarding cell cycle distribution, carcinomas displayed a higher proportion of both S-phase (p = 0.0003) and G2/M-phase (p = 0.0006) cells with respect to benign hyperplasias. Aneuploid cases also showed a greater proliferation rate as compared to the diploid carcinomas, regardless of their cytopathologic grade (p = 0.00001). Despite the fore-mentioned results, these correlations were far from being absolute, suggesting that combined assessment of these parameters should give additional information for the clinical management of prostatic disease.(ABSTRACT TRUNCATED AT 250 WORDS)