TRANSRECTAL FINE-NEEDLE ASPIRATION BIOPSY OF THE PROSTATE COMBINING CYTOMORPHOLOGIC, DNA-PLOIDY STATUS AND CELL-CYCLE DISTRIBUTION STUDIES

Fine needle aspiration (FNA) cytology of the prostate is becoming a co mmon diagnostic procedure, and DNA flow cytometry (FCM) data have been shown to correlate with the pattern of evolution of prostatic carcino ma, thus emphasizing the importance of assessing both parameters toget her. The aim of the present paper is to analyze the presence of DNA an euploidy, cell cycle distribution and their relationship with the cyto logic grade in transrectal fine needle aspiration prostate biopsies fr om 78 consecutive patients. Herein we studied the DNA ploidy status, t he cell cycle distribution and their relationship with cytologic grade in transrectal FNA biopsies of the prostate from 78 consecutive patie nts -47 benign hyperplasias and 31 carcinomas- as analyzed by a reprod ucible FCM method for single cell suspension preparations, data acquis ition and analysis. The presence of DNA aneuploidy was detected in 39% of the carcinomas and it was found to be a specific marker for prosta tic carcinoma since all benign hyperplasia cases were diploid. Moreove r, the incidence of DNA aneuploidy increased progressively from well-d ifferentiated to moderately-differentiated and poorly-differentiated c arcinomas (p=0.005). Regarding cell cycle distribution, carcinomas dis played a higher proportion of both S-phase (p=0.0003) and G2/M-phase ( p=0.0006) cells with respect to benign hyperplasias. Aneuploid cases a lso showed a greater proliferation rate as compared to the diploid car cinomas, regardless of their cytopathologic grade (p=0.00001), Despite the fore-mentioned results, these correlations were far from being ab solute, suggesting that combined assessment of these parameters should give additional information for the clinical management of prostatic disease. We suggest that combined assessment of cytomorphology, the DN A ploidy status and cell cycle studies in prostatic transrectal FNA bi opsy may contribute to a rapid and accurate diagnosis of prostatic dis ease and should presumably contain valuable prognostic information.