Diagnostic effect of an improved preembedding method of prostate needle biopsy specimens

The authors compared the influence of a conventional and an optimized submi tting method of prostate core needle biopsy specimens on the frequency of c ancer detected and the pathologic characteristics of the adenocarcinoma bea ring biopsy specimens. The patients included were part of the prostate-spec ific antigen (PSA) screening program of Tyrol/Austria. Of the systematic co re needle biopsy specimens from 500 unselected men obtained within 1 year f rom the Urological Department, University of Innsbruck, the core biopsy spe cimens of 250 cases were submitted conventionally, floating free in formali n-filled containers, whereas the biopsy specimens of the other 250 cases we re stretched and orientated between 2 meshes in tissue cassettes at the tim e of biopsy before formalin fixation. On 136 cases diagnosed as adenocarcin oma the number and the length of cores as well as number of the cores invol ved by cancer and the tumor size were morphometrically determined. The diag nosis of benign prostatic hyperplasia, isolated high-grade prostatic in tra epithelial neoplasia (PIN), atypical foci suspicious for cancer, and carcin oma was made in 66%, 5.6%, 4.8%, and 23.6% after conventional submission an d in 61.6%, 6.4%, 1.2%, and 30.8% of the cases after optimized preembedding respectively. Zn the adenocarcinoma cases the optimizedly preembedded mate rial showed higher mean total core length (126.5 mm versus 93.9 mm; P < .00 01), a higher mean total tumor length (14.1 mm versus 8.6 mm; P = .01), and more cores involved by cancer (2.9 versus 2.4; P = .01) compared with the conventionally worked-up biopsy specimens. Optimized preembedding of core n eedle biopsy specimens in tissue cassettes could be quickly and routinely d one by the assistance of the urologists at the time of biopsy. The signific ant improvement of the histologic yield of optimizedly preembedded prostati c needle biopsy specimens led to a higher frequency of cancer diagnosis, a reduction of cases with atypical foci suspicious for cancer and a significa ntly lower number of cases with only 1 core biopsy involved by cancer. Copy right (C) 2000 by W.B. Saunders Company.