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Category: Volume 09 Issue 02 February 2021
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Title: Study of Perineural Invasion in Prostatic Carcinoma

Authors: Dr Alvin Vincent, Dr Sankar S, Dr Sheeja S

 DOI: https://dx.doi.org/10.18535/jmscr/v9i2.36

Abstract

Background: Prostatic carcinoma is the most common cancer in elderly men and 75-80% occur in peripheral zone. It is diagnosed by architectural, nuclear, cytoplasmic and intraluminal features. Perineural invasion is one of the pathognomonic histological features of adenocarcinoma and its significance was studied.

Objectives

Primary Objective

  1. To describe perineural invasion in prostatic carcinoma.
  2. To identify proportion of patients with perineural invasion having metastatic prostatic carcinoma.
  3. To find out the association of perineural invasion and metastatic prostatic carcinoma.

Secondary Objective

  1. To describe the use of S100 expression in enhancing detection of perineural invasion by demonstration of nerves.

Methods:

Study Design : Cross sectional analytical study

Study Population: Study sample includes all the cases of prostatic carcinoma biopsy specimens received in the Department of Pathology during the study period.

Sample Size : 155

Sampling Procedure :Continuous sampling

Results and Discussion: The mean age of the study population was 68.72 years. The predominant Gleason score was 7 in 40.5% of cases, 4+3 and 3+4 respectively. Perineural invasion was found in 46% cases. PNI was seen in 57% of Gleason scores 8-10 and 35% in Gleason score 7. PNI and its association with metastatic prostate carcinoma had weak positive relationship between the two variables.51% of cases showed PNI by S100 immunohistochemistry.

Conclusion: In the present study, perineural invasion was found in 46% of the biopsy specimens and was associated with higher grade prostatic carcinomas. The significance of PNI in metastatic prostate carcinoma could not be proved as there was only weak positive relationship between PNI and metastatic prostatic carcinoma. Our data showed 5% increase in detection of PNI which suggested that detection of perineural invasion may be enhanced by S100 immunohistochemistry.

Keywords: Prostatic carcinoma, Perineural invasion, metastasis, Gleason score, PSA, S100.

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Corresponding Author

Dr Alvin Vincent

Junior Resident, Department of Pathology, Government Medical College, Kottayam, Kerala, India