HISTOMORPHOLOGICAL CHARACTERISTICS OF PROSTATE SPECIMENS ANALYZED AT A REFERRAL HOSPITAL IN KENYA

Abstract

Background: Global shift to high energy foods is important risk factor for new variants of prostate cancer. Some prostate tumors have an indolent course while others have an aggressive course; therefore, knowledge of tumor subtypes can help in clinical decision-making based on the patient profile. Methods: The main aim of the study was to determine the histomorphological characteristics of prostate specimens analyzed at regional referral hospital. The study was a cross[1]sectional retrospective study. The target specimens in this study consisted of prostate specimens that had prostate specific antigen level and were analyzed and reported between 2017 and 2022 at Jaramogi Odinga Oginga teaching and referral hospital, Kisumu Kenya. Results: Prostate color was not reported in eight reports. Of the 72 specimens observed, 50 (69.4%) were reported to be white, 12 (16.7%) were reported to be tan/white, 9 (12.5%) were tan brown, and 1 (1.4%) was tan grey. There was significant variation (p=0.001) in prostate specimen color. Of the 80 specimens, 47 (58.75%) had coarse surface, 16(20.00%) nodulated surfaces and 17 (21.25%) shrunken surfaces. There was variation in prostate surfaces (p<0.00001, X 2=23.275). Majority of specimens 55 (68.8%) measured between 0-29 mm, 12 (15%) measured 30-59 mm, 7 (8.8%) measured 60-89, 3 (3.8%) measured 90-119, 2 (2.5%) measured >150 mm and 1 (1.3%) measured 120-149 mm. There was no significant difference in the prostate biopsy sizes in comparison to the mean (p=0.984, t=0.020, 95% CI). The majority 20 (25%), of specimens had prostate cancer 15 (18.75%) had atypical findings, and 2 (2.5%) had high-grade proliferative intraepithelial neoplasia. The microscopic features of the groups did not differ significantly (F2, 34 = 1.469, p = 0.244). There is positive correlation between Gleason scores and Prostate specific antigen levels (p = 0.004, r = 0.474). Conclusion: There is variation of specimen color in prostate specimen with prostate cancer implying that advanced prostate disease causes changes in prostate color. Atypical prostate findings are common in age 50-59 which may suggest that targeted prevention and intervention should focus on this age group. Higher Gleason scores are likely to be observed in patients with higher PSA levels among patients being evaluated for prostate tumors.