Is cytology capable of adequately grading prostate carcinoma? Matched series of 50 cases comparing cytologic and...

A perceived disadvantage of fine-needle aspiration biopsy of the prostate is that aspiration biopsies cannot be correlated with current tissue-grading systems. We compared patterns of cellular arrangement among 50 cases of prostate carcinoma studied in histologic and cytologic specimens obtained simultaneously. Cell patterns were independently scored in a semiquantitative fashion on both histologic and cytologic material, and "predicted Gleason scores" were assigned to the cytologic specimens. When carcinomas were classified as well differentiated (Gleason score 2 to 4), moderately differentiated (Gleason score 5 to 7), or poorly differentiated (Gleason score 8 to 10), there was 84 per cent agreement between histology and cytology. In no instance was there overlap between well-differentiated and poorly differentiated adenocarcinoma in the matched specimens. We believe that it is possible to accurately predict tissue patterns of prostate carcinoma and to estimate Gleason scores in aspiration biopsy specimens.