Histopathologic characterization of prostate diseases in Madinah, Saudi Arabia

Assessment of the value of the different variants of abnormal digital rectal examination finding in predicting carcinoma of the prostate: a preliminary report of a two-center study

Background

Digital rectal examination is a veritable tool for the clinical diagnosis and screening for carcinoma of the prostate. This study aims to assess the value of the different variables which constitute abnormal digital rectal examination (DRE) findings.

Results

Following ethical approval, one hundred and thirty-one men met the inclusion criteria and were enrolled in the study. The peak incidence of abnormal DRE finding was in the 8th decade of life, while the PPV was 66.5%. Of the total, 44 (33.5%) were nodular hyperplasia, 12 (9.2%) were prostate intra-epithelia neoplasia, while 75 (57.3%) were adenocarcinoma. With a positive predictive value (PPV) of 73.3%, a hard nodular feel was the only abnormal DRE finding that independently and significantly predicted the risk of prostatic adenocarcinoma. A suspicious nodule and obliterated median groove had PPV of 23.1% and lobar asymmetry, 0%. There was a statistically significant correlation (P = 0.005) between DRE findings and histology, between PSA and histology (P = 0.000) and between the size of the prostate and PSA value (P = 0.021). The mean size of the prostate was 101.2 g, standard deviation 92.11783, maximum 648 g and minimum 13.6 g.

Conclusion

Most of the variants of abnormal DRE findings do not sufficiently predict the risk of adenocarcinoma on their own. They need to be in combination with other DRE findings or a raised PSA to significantly predict adenocarcinoma.

Histopathological diagnoses and patterns in transrectal ultrasound-guided prostatic biopsy series from a large tertiary care center in Saudi Arabia

Aim

The aim of the study was to report our transrectal ultrasound (TRUS)-guided prostatic biopsy histopathological diagnoses and clinical findings in our prostate cancer patients in a tertiary care center.

Methods

We have reviewed our TRUS biopsy series done in our department from January 2011 to December 2016. We reviewed our patient's prebiopsy prostate-specific antigen (PSA) findings and the histopathological diagnoses and determined the clinical and pathological features of prostate cancer patients in our series.

Results

A total of 398 patients underwent 12 core TRUS biopsies. Benign prostatatic hyperplasia was found in 48.5% of the patients and prostate cancer was found in 113 patients (28.4%). Among them, metastatic prostate cancer was found in 51.7% of them. High Gleason score (8-10) was found in 56.6% and a PSA of more than 20 was found in 63.3% of the patients.

Conclusion

We recommend a mass public awareness program to encourage our patients to seek early prostate cancer screening and to alert the medical community to encourage more awareness of prostate cancer screening.

Epidemiology of cancer in Saudi Arabia thru 2010-2019: a systematic review with constrained meta-analysis

Background

Cancer is emerging as a major global health-care system challenge with a growing burden worldwide. Due to the inconsistent cancer registry system in Saudi Arabia, the epidemiology of cancer is still dispersed in the country. Consequently, this review aimed to assemble the epidemiological metrics of cancer in Saudi Arabia in light of the available published data during the period from (2010–2019).

Methods

Published literature from Saudi Arabia relating to cancer incidence, prevalence, risk factors, and other epidemiological metrics were accessed through electronic search in Medline/PubMed, Cochrane, Scopus, Web of Knowledge, Google Scholar, and public database that meet the inclusion criteria. Relevant keywords were used during the electronic search about different types of cancers in Saudi Arabia. No filters were used during the electronic searches. Data were pooled and odds ratios (ORs) and 95% confidence interval (95%CI) were calculated. A random-effects meta-analysis was performed to assess the well-determined risk factors associated with different types of cancers.

Results

The most common cancers in Saudi Arabia are breast, colorectal, prostate, brain, lymphoma, kidney and thyroid outnumbering respectively. Their prevalence rates and OR (95%CI) as follow: breast cancer 53% and 0.93 (0.84–1.00); colon-rectal cancer (CRC) 50.9% and 1.2 (0.81–1.77); prostate cancer 42.6% and 3.2 (0.88–31.11); brain/Central Nervous System cancer 9.6% and 2.3 (0.01–4.2); Hodgkin and non-Hodgkin's lymphoma 9.2% and 3.02 (1.48–6.17); kidney cancer 4.6% and 2.05 (1.61–2.61), and thyroid cancer 12.9% and 6.77 (2.34–19.53).

Conclusion

Within the diverse cancers reported from Saudi Arabia, the epidemiology of some cancers magnitude 3-fold in the latest years. This increase might be attributed to the changing in the Saudi population lifestyle (adopting western model), lack of cancer awareness, lack of screening & early detection programs, social barriers toward cancer investigations. Obesity, genetics, sedentary lifestyle, tobacco use, viral infection, and iodine & Vit-D deficiency represent the apparent cancer risk factors in Saudi Arabia.

Histopathological pattern of testicular diseases in western Saudi Arabia

Objectives

To determine the histopathological pattern of testicular diseases among Saudi patients in Madinah, Saudi Arabia.

Methods

This retrospective histopathology-based study was conducted in a tertiary care hospital in Madinah, Saudi Arabia, from January 2006 to December 2017. The data collected were entered into MS-Excel and analyzed using the Statistical Packages for Social Sciences Version 19.

Results

Of the 199 testicular specimens received, 108 (54.3%) of the biopsies were taken for diagnostic test, while 91 (45.7%) were for therapeutic test. The male infertility was the only indication in the diagnostic group, accounting for 108 (54.3%) with a mean age of 28±7.9 years. Benign conditions of the testes were the most common indication in the therapeutic group accounting for 76 cases (38.2%), followed by 15 cases (7.5%) of testicular tumors. Hemorrhagic infarction from testicular torsion was the most common histologic patterns in benign testicular conditions group, accounting for 46 (23.2%) of the cases with a mean age of patients 32.1±8.1 years. Mixed non-seminomatous germ cell tumor was the most common primary tumor in 7 (3.5%) cases, followed by seminoma occurring in 5 (2.5%) cases. Mean ages for these patients were 33.7±8.1 years for primary tumor and 35.6±9.1 years for seminoma.

Conclusions

The pattern of testicular diseases on the basis of histopathology experience in the Madinah region appears to conform to world literature and KSA.

A Clinicopathological Profile of Prostate Cancer in Trinidad and Tobago

Aim. To conduct a clinicopathological review of all prostate biopsies performed in a tertiary referral centre in Trinidad and Tobago over a period of 30 months. Methods. The records of all patients who had prostate biopsies from January 2012 to July 2014 were reviewed. Clinical and pathologic data were compiled and subsequently analysed using SPSS version 20. Results. From January 2012 to July 2014, 617 transrectal ultrasound guided prostate biopsies were performed. Pathological data were found for 546 patients of whom 283 (51.8%) were confirmed carcinoma of the prostate. Moderately differentiated tumors (Gleason 7) were the most common group. Using the D'Amico risk classification, most cases were found to be high risk (63.1%). Afro-Trinidadians comprised 72.1% of the patients with prostate cancer. Afro-Trinidadians were also more likely to have high risk and high grade disease as well as high PSA values. Conclusion. This study demonstrates that over half of our biopsies are eventually positive for cancer and most cases were high risk. Afro-Trinidadians comprised a disproportionate number of those diagnosed with prostate cancer and had a greater risk of high risk disease.

A histopathological study of prostate lesions in Lagos, Nigeria: A private practice experience

Introduction:

Prostatic carcinoma (CaP) is globally the second most frequently diagnosed cancer and the sixth leading cause of cancer death in males. The aim of this study is to determine the pattern of histopathological types of prostatic lesions seen in a private laboratory in Lagos, Nigeria.

Materials and Methods:

Histopathological reports of all prostate specimens, which were received and processed by histopathology section of a private laboratory in Lagos, Nigeria, from August 2009 to December 2013 were reviewed.

Results:

A total of 304 prostatic tissue specimens were received and processed during the period under review. The youngest patient was 32 years old while the oldest patient was 99 years old with a mean of 67.8 years ± 9.5. The most common diagnosis was benign prostatic hyperplasia (BPH) (62.8%), distantly followed by CaP (29.3%), inadequate samples (6.6%), prostatic intraepithelial neoplasia (1%), and metastasis to the prostate (0.3%). The peak incidence was age group of 60-69 years, closely followed by 70-79 years accounting for 38.2% and 36.2%, respectively. Moderately differentiated CaP (Gleason scores [GSs] 5-7) accounted for 58.1% of the cases while GS 7 was the most common individual score and was seen in 32.3% of the CaP cases.

Conclusion:

In this private practice, BPH is the most common prostate lesion. CaP is relatively high and most of the cases have a high GS that portends high mortality in our population. Efforts should be made to increase awareness so as to reduce the mortality.

Frequency of Unnecessarily Biopsies among Patients with Suspicion of Prostate Cancer in Syrian Men

BACKGROUND

The prevalence of prostate cancer is considered high in many countries, and screening tests are very important in order to detect prostate cancer in its early stages; however false positivity with these screening tests means that a lot of patients undergo unnecessary biopsy, which is an invasive procedure, for the confirmatory test. The purpose of this study was to estimate the frequency of unnecessary biopsy cases in patients referred for prostate biopsy in one of the most important and overload cancer centers in Syria.

MATERIALS AND METHODS

Retrospective data for a period of four years between January 2009 and December 2012 were collected in Al- Bayrouni University Medical hospital in Damascus, Syria. The patients from whom data were collected were referred to our histopathological department because of elevated prostate specific antigen (PSA) serum or an abnormal digital rectal examination (DRE). All patients underwent prostatic TRUS-guided biopsies. Diagnosis of prostate cancer (PCa) or benign prostatic hyperplasia (BPH) was based on histopathological examination and prostate cancers cases were graded and scored according to the Gleason score system.

RESULTS

For the 406 patients referred to biopsy, the mean±SD age was 58.4 ±23.3 years. The mean ± SD PSA level was 49.2±21.5 ng/ ml. Of the total we found 237 patients diagnosed with PCa (58. 4%), 166 patients with BPH (40.9%) and 3 cases were unable to be diagnosed (0.7%) because of biopsy collection errors.

CONCLUSIONS

Our study shows that a high percentage of patients are undergoing unnecessary biopsy, which suggests that the performed screening tests had a high level of false positive and may need re-evaluation.