CORRELATION OF DNA-PLOIDY AND HISTOLOGIC DIAGNOSIS FROM PROSTATE CORE-NEEDLE BIOPSIES - IS DNA-PLOIDY MORE SENSITIVE THAN HISTOLOGY FOR THEDIAGNOSIS OF CARCINOMA IN SMALL SPECIMENS

DNA ploidy has been shown to have prognostic value in adenocarcinoma o f the prostate. While occasional benign lesions of the prostate may be associated with a DNA aneuploid status, most aneuploid epithelial pro liferations of the prostate are carcinomas. Because of the relationshi p between aneuploidy and malignancy, DNA ploidy analysis might improve detection of adenocarcinoma in small core-needle biopsy specimens. In this study, DNA ploidy analysis was performed on 186 fresh core biops ies from 32 patients who had undergone transrectal, ultrasonographical ly directed core-needle biopsies. Ploidy level was determined by Feulg en staining and image analysis with a CAS 200(TM) image analyzer (Bect on Dickinson-Cellular Imaging Systems, San Jose, CA). The resultant DN A ploidy levels were compared with the initial histologic diagnosis an d subsequent clinical and pathologic follow-up. Nondiploid DNA pattern s correlated with a diagnosis of carcinoma on core biopsy in 11 of 16 nondiploid cases and with a final diagnosis of malignancy in 13 of 16 nondiploid cases. Two patients with biopsy proven carcinoma had DNA di ploid tumor patterns. Ploidy analysis had a sensitivity of 86.6% and a specificity of 73.7% in predicting the final diagnosis of malignancy. One case interpreted as DNA tetraploid by image analysis revealed sem inal vesicle tissue on both the cytologic preparations and the core bi opsy. Two DNA aneuploid specimen associated with cores' initially read as benign or atypical demonstrated adenocarcinoma either on review of the original core biopsy or the prostatectomy specimen. The final DNA aneuploid specimen revealed acute prostatitis in the core biopsy. DNA ploidy analysis of core biopsy specimens appears to have relatively g ood specificity and sensitivity for the detection of prostatic carcino ma. Sampling errors appear to be the major cause of false negative res ults. Inappropriate measurement of seminal vesicle tissue and acute pr ostatitis can result in false positive results. (C) 1996 Wiley-Liss, I nc.