Clinicopathological Correlation of Prostatic Lesions with Serum PSA Levels: An Observational Analysis

Home > 2025, Vol. 11 No. 02 > Clinicopathological Correlation of Prostatic Lesions with Serum PSA Levels: An Observational Analysis

Published: November 11, 2025

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Authors

Pooja Khandwe, Sheela Chikhalikar, Dimple Kalsi3, and Archana Patil

DOI Number
https://doi.org/10.15415/jmrh.2025.112008

Keywords
Prostate, Benign prostatic hyperplasia, Prostate carcinoma, PSA, Gleason score

Abstract

Background: Prostatic diseases, including benign prostatic hyperplasia (BPH), prostatitis, and carcinoma, are common in elderly males and contribute significantly to morbidity. Serum prostate-specific antigen (PSA) is widely used as a diagnostic and monitoring tool, though its specificity for malignancy is limited.

Purpose: To evaluate the clinicopathological correlation of various prostatic lesions with serum PSA levels and age distribution.

Methods: This observational study was conducted in the Department of Pathology at a tertiary care center in Nashik from August 2019 to December 2021. A total of 110 prostatic specimens, including TURP chips, needle biopsies, and open prostatectomy specimens, were analyzed. Histopathological examination, Gleason grading, and serum PSA measurement were performed. Data were analyzed using EpiInfo 7.2, with p < 0.05 considered statistically significant.

Results: Among 110 specimens, TURP was most frequent (68.18%), followed by needle biopsy (26.36%) and open prostatectomy (5.45%). BPH was the predominant lesion (76.36%), while carcinoma accounted for 17.27% of cases. The 61–70-year age group had the highest incidence of both benign and malignant lesions (46.36%). Mean serum PSA was significantly higher in malignant lesions (89.82 ± 52.32 ng/ml) and atypical small acinar proliferation (54.93 ± 65.08 ng/ml) compared to BPH and PIN (7.56 ± 12.38 ng/ml). Gleason scores 7 and 8 were most frequent among carcinoma cases (31.57% and 31.57%, respectively).

Conclusion: BPH is the most common prostatic lesion in elderly males, while PSA levels correlate strongly with malignancy and atypical lesions. Histopathological evaluation and Gleason scoring remain essential for diagnosis and management.

References

Akhter, R., Reshi, R., Dar, Z. A., & Dar, P. A. (2014). Histopathological study of prostatic lesions on needle biopsies with serum prostate-specific antigen (PSA). International Journal of Medicine and Medical Sciences, 6(3), 87–91. https://www.globalscienceresearchjournals.org/articles/histopathological-study-of-prostatic-lesions-on-needle-biopsies-with-serum-prostatespecific-antigen-psa.pdf
Arshad, H., & Ahmad, Z. (2013). Overview of benign and malignant prostatic disease in Pakistani patients: A clinical and histopathological perspective. Asian Pacific Journal of Cancer Prevention, 14(5), 3005–3009. https://doi.org/10.7314/apjcp.2013.14.5.3005
Arya, R., Minj, M., Tiwari, A. K., Bhardwaj, A., Singh, D., & Deshkar, A. M. (2015). Pattern of prostatic lesions in Chhattisgarh Institute of Medical Sciences, Bilaspur: A retrospective tertiary hospital-based study. International Journal of Scientific Study, 3(6), 179–182. https://doi.org/10.18203/2320-6012.ijrms20172095
Begum, Z., Attar, A. H., Tengli, M. B., & Ahmed, M. M. (2015). Study of various histopathological patterns in TURP specimens and incidental detection of carcinoma prostate. Indian Journal of Pathology and Oncology, 2(4), 303–308. https://ijpo.co.in/archive/volume/2/issue/4/article/17354
Bhat, S., Chaudhri, S., Bhat, P., & Hatwal, D. (2015). Histopathological study of prostatic diseases in Garhwal region. International Journal of Scientific Study, 3(8), 136–140. https://www.ijss-sn.com/uploads/2/0/1/5/20153321/ijss_nov_oa31.pdf
Cotran, R. S., Kumar, V., & Collins, T. (1999). Robbins pathologic basis of disease (6th ed.). W.B. Saunders Company.
Deshmukh, B. D., Ramteerthakar, N. A., & Sulhyan, K. R. (2014). Histopathological study of lesions of prostate: A five-year study. International Journal of Health Sciences and Research, 4(1), 1–9. https://www.ijhsr.org/IJHSR_Vol.4_Issue.1_Jan2014/1.pdf
Gami, H. J., Patil, V. S., Patil, S. R., Jawalkar, S. A., & Barate, S. S. (2025). Correlation of immunohistochemical expression of alpha-methyl acyl-coenzyme A racemase/p504s with Gleason grade and serum PSA level in prostate carcinoma. Medical Journal of Dr. D.Y. Patil Vidyapeeth, 18(1), 105–110. https://doi.org/10.4103/mjdrdypu.mjdrdypu_58_23
Garg, M., Kaur, G., Malhotra, V., & Garg, R. (2013). Histopathological spectrum of 364 prostatic specimens including immunohistochemistry with special reference to grey zone lesions. Prostate International, 1(4), 146–151. https://doi.org/10.12954/PI.13026
Hameed, O., & Humphrey, P. A. (2005). Immunohistochemistry in diagnostic surgical pathology of the prostate. Seminars in Diagnostic Pathology, 22(1), 88–104. https://doi.org/10.1053/j.semdp.2005.11.001
Hirachand, S., Dangol, U., Pradhanang, S., & Acharya, S. (2017). Study of prostatic pathology and its correlation with prostate-specific antigen level. Journal of Pathology of Nepal, 7(1), 1074–1077. https://doi.org/10.3126/jpn.v7i1.16911
Humphrey, P. A. (2017). Histopathology of prostate cancer. Cold Spring Harbor Perspectives in Medicine, 7(10), a030411. https://doi.org/10.1101/cshperspect.a030411
Joshee, A., & Sharma, K. C. (2015). The histomorphological study of prostate lesions. Journal of Dental and Medical Sciences, 14(1), 85–89. https://www.iosrjournals.org/iosr-jdms/papers/Vol14-issue11/Version-8/P0141188589.pdf
Kiehl, R., Lemos, A., Stavalle, J., & Ortiz, V. (2001). Correlation between chronic prostatitis and prostate-specific antigen values. International Brazilian Journal of Urology, 27(1), 42–45. https://www.brazjurol.com.br/janeiro_2001/Kiehl_42_45.pdf
Koshy, A., & Bavikar, R. (2021). Utility of p63 and AMACR in differentiating benign and malignant prostatic lesions. Annals of Pathology and Laboratory Medicine, 8(2), A39–A44. https://doi.org/10.21276/apalm.2744
Londhe, A. M., & Shah, A. B. (2018). Prostate-specific antigen (PSA) levels and its correlation to prostatic lesions. Annals of Pathology and Laboratory Medicine, 5(12), 894–899. https://doi.org/10.21276/apalm.2268
Mainali, N., Nepal, N., Chaudhary, P. K., & Shrestha, J. (2018). Study on correlation between serum prostate-specific antigen and various prostatic pathology. Nepalese Medical Journal, 1(2), 70–73. https://doi.org/10.3126/nmj.v1i2.21579
Maru, A. M., Makwana, H. H., Lakum, N. R., Chokshi, T., Agnihotri, A., Trivedi, N., & Joshi, J. (2014). Study on correlation between prostate-specific antigen (PSA) and various prostatic pathology. International Journal of Medical Science and Public Health, 3(6), 735–738. https://doi.org/10.5455/ijmsph.2014.040420142
Mishra, S. K. C., Sahu, B. K., Kar, S. S., Dixit, S., & Dash, A. P. (2023). Clinicopathological correlation of various prostatic lesions with serum prostate-specific antigen level: A hospital-based cross-sectional study. National Journal of Physiology, Pharmacy and Pharmacology, 13(6), 1323–1328. https://doi.org/10.5455/njppp.2023.13.04200202312052023
Muthuvel, E., Chander, V. R., & Srinivasan, C. (2018). Clinicopathological study of associated lesions in benign prostatic hyperplasia and prostatic adenocarcinoma in surgical biopsy specimens. Annals of Pathology and Laboratory Medicine, 5(2), 158–164. https://doi.org/10.21276/APALM.1608
Nadler, R. B., Humphrey, P. A., Smith, D. S., Catalona, W. J., & Ratliff, T. L. (1995). Effect of inflammation and benign prostatic hyperplasia on elevated serum prostate-specific antigen levels. The Journal of Urology, 154(2), 407–413. https://doi.org/10.1097/00005392-199508000-00023
Niang, L., Kouka, C. N., Jalloh, M., & Gueye, S. M. (2011). Screening for prostate cancer by digital rectal examination and PSA determination in Senegal. International Scholarly Research Notices, 2011, 943704. https://doi.org/10.5402/2011/943704
Pushpa, N., Goyal, R., & Bhamu, S. (2024). Histopathological spectrum of prostatic lesions and their correlation with serum prostate-specific antigen levels. Asian Journal of Pharmaceutical and Clinical Research, 17(2), 36–39. https://doi.org/10.22159/ajpcr.2024.v17i2.48487
Puttaswamy, K., Parthiban, R., & Shariff, S. (2016). Histopathological study of prostatic biopsies in men with prostatism. Journal of Medical Science, 2(12), 10.46347. https://doi.org/10.46347/jmsh.2016.v02i01.003
Rajani, R., Mehta, N., & Goswami, H. (2020). Histopathological study of prostatic lesions at tertiary care centre. International Journal of Clinical and Diagnostic Pathology, 3(2), 172–176. https://doi.org/10.33545/pathol.2020.v3.i2c.249
Ramatlho, P., Rugemalila, M. M., Tawe, L., Pain, D., Choga, O. T., Ndlovu, A. K., Koobotse, M. O., Lal, P., Rebbeck, T. R., & Paganotti, G. M. (2025). The role of immunohistochemistry for AMACR/p504s and p63 in distinguishing prostate cancer from benign prostate tissue samples in Botswana. Research and Reports in Urology, 17, 1–10. https://doi.org/10.2147/RRU.S492935
Sabalpara, M. A., Parikh, S. B., & Parikh, B. J. (2019). Histopathological study of prostatic lesions. National Journal of Integrated Research in Medicine, 10(5), 58–63. https://doi.org/10.70284/njirm.v10i5.2590
Satyasri, K., Sinha, S., & Kartheek, B. (2018). Spectrum of prostatic lesions in a tertiary care hospital: A five-and-a-half-year retrospective study. Journal of Evolution of Medical and Dental Sciences, 7(36), 3991–3996. https://doi.org/10.14260/jemds/2018/891
Sharma, A., Sharma, M., Gandhi, S., Khajuria, A., & Goswami, K. (2017). Histomorphological spectrum of prostatic lesions: A retrospective analysis of transurethral resection of prostate specimens. International Journal of Research in Medical Sciences, 5(6), 2373–2378. https://doi.org/10.18203/2320-6012.ijrms20172095
Shekhar, S., Kumari, S., Tripathy, S., & Akhtar, M. J. (2019). Evaluation of prostate-specific antigen levels and its correlation with histopathological findings in a tertiary care hospital in Bihar. Journal of Clinical and Diagnostic Research, 13(8), 1–4. https://ijmrp.com/Admin_Portal/Upload/Vol5Issue5/12%20IJMRP%205(6)%2048-51.pdf
Tavethiya, N. J. (2025). Study of histopathological spectrum in various prostatic lesions in transurethral resection of prostate specimen. International Journal of Research in Medical Sciences, 13(1), 1916–1919. https://doi.org/10.18203/2320-6012.ijrms20251030
Vani, B., Kumar, D., Sharath, B., Murthy, V., & Geethamala, K. (2015). A comprehensive study of prostate pathology in correlation with prostate-specific antigen levels: An Indian study. Clinical Cancer Investigation Journal, 4(5), 617–620. https://doi.org/10.4103/2278-0513.164722
Yadav, M., Desai, H., & Goswami, H. (2017). Study of various histopathological patterns in prostate biopsy. International Journal of Current Research and Review, 9(21), 58–63. https://doi.org/10.7324/IJCRR.2017.9219

How to Cite

Pooja Khandwe, Sheela Chikhalikar, Dimple Kalsi3, and Archana Patil. Clinicopathological Correlation of Prostatic Lesions with Serum PSA Levels: An Observational Analysis. J. Multidiscip. Res. Healthcare. 2025, 11, 61-70

Clinicopathological Correlation of Prostatic Lesions with Serum PSA Levels: An Observational Analysis

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Issue-2	December
ISSN Print	2393-8536
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