Histopathological Spectrum of Prostatic Lesions and Correlation with Total Serum Prostate-Specific Antigen: A Prospective Observational Study

Abstract

Background: Prostatic lesions range from benign hyperplasia to malignant lesions, with serum prostate-specific antigen (PSA) serving as an important biomarker for screening and disease monitoring. However, PSA levels often overlap between benign and malignant conditions, making histopathological confirmation essential.
Objective: To evaluate the histopathological spectrum of prostatic lesions and correlate findings with serum PSA levels.
Methods: This prospective observational study was conducted at DMCH from February 2025 to October 2025, including 90 patients presenting with lower urinary tract symptoms. Serum PSA levels were measured, and histopathological examination was performed on biopsy or resection specimens. Statistical correlation between PSA levels and histological diagnoses were analyzed.
Results: Benign prostatic hyperplasia (BPH) was the most common lesion (62.2%), followed by prostatitis (15.6%), carcinoma (16.7%), and prostatic intraepithelial neoplasia (PIN) (5.5%). Mean PSA levels were significantly higher in malignant lesions (36.8 ± 12.4 ng/mL) compared to benign conditions (6.2 ± 3.1 ng/mL) (p < 0.001). A strong positive correlation was observed between elevated PSA levels and malignancy.
Conclusion: PSA is a useful screening tool but lacks specificity. Histopathological examination remains the gold standard for diagnosis. Combined evaluation improves diagnostic accuracy.