Abnormal prostatic cells in ejaculates from men with prostatic cancer--a preliminary report

Area of Science:

• Urology
• Oncology
• Cytopathology

Background:

• Prostate cancer diagnosis relies on invasive methods like digital rectal examination (DRE) and prostate-specific antigen (PSA) testing.
• Transrectal ultrasonography (TRUS)-guided prostatic biopsies are the established reference standard for histopathological diagnosis.
• There is a need for non-invasive and easily repeatable diagnostic approaches for prostate cancer.

Purpose of the Study:

• To evaluate ejaculate cytology as a novel, non-invasive method for detecting prostate cancer.
• To correlate ejaculate cytology findings with histopathology from TRUS-guided biopsies.
• To assess the utility of ejaculate cytology in patients with abnormal DRE and/or elevated PSA levels.

Main Methods:

• Ejaculate specimens were collected from 37 men suspected of prostate cancer and 32 healthy controls.
• Cytological examination and immunohistochemical staining for PSA and prostatic acid phosphatase (PAP) were performed on ejaculate samples.
• TRUS-guided sextant biopsies were conducted for histopathological analysis.

Main Results:

• Abnormal prostatic cells were detected in ejaculate specimens from 14 of 37 patients.
• Seven of 12 patients (75%) with malignant TRUS biopsies had abnormal cells in their ejaculate.
• Five patients with negative biopsies showed abnormal ejaculate cytology, including two with high-grade prostatic intra-epithelial neoplasia (PIN).

Conclusions:

• Ejaculate cytology is a potentially valuable, non-invasive tool for early prostate cancer detection.
• Further research is needed to establish the clinical significance and role of ejaculate cytology, particularly in relation to PSA and TRUS biopsy.
• The findings suggest ejaculate cytology may complement existing diagnostic methods for prostate cancer.