The value of fine-needle aspiration biopsy in prostatic carcinoma, in comparison with core biopsy histology

Summary

Patients in whom an abnormal rectal examination leads to the suspicion of prostatic carcinoma underwent both fine-needle aspiration biopsy for cytological evaluation and core biopsy for histological evaluation. The data from 826 paired observations, collected over a 7-year period are compared. The material available was inadequate for cytology in 94 cases (11.4%) and for histology in 18 cases (2.2%). Cytology results were classified as positive (Papanicolaou 4–5) or negative (1–3) for carcinoma, and histology results as indicative of malignancy or no proven malignancy. Initially the cytology results correlated with the histology results in 84.4%, with a sensitivity of 89.7% and a specificity of 81.5%. After revision of all discrepant slides these figures increased to 88.6%, 92.8% and 86.4%, respectively. Clinical or histological follow up of patients with discrepant results was conclusive in 36 patients, giving evidence of malignancy in 24 patients and of benign pathology in 12. In this “discrepancy” group, comparison of both cytological and histological results with these clinical data gave a sensitivity for cytology of 63% as against 37% for histology, and a specificity for cytology of 17%, as against 83% for histology. It is concluded that fine-needle aspiration biopsy cytology is a reliable, simple and sensitive technique that can be used to confirm a suspicion of prostatic carcinoma.