Perineural invasion, Gleason score and prostate specificantigen; is there any association?

Prostatic cancer is one of the most common malignancies among males. Perineural invasion (PNI) is a common finding of prostate cancer associated with more aggressive malignancies.

The current study was conducted to assess the association of PNI with serum prostate specific antigen (PSA) and Gleason score.

This analytical cross-sectional study conducted on 354 known cases of prostatic cancer (2015 until 2017). Patients’ last PSA and Gleason score wit h presence/lack of PNI in their prostate biopsies were recorded. The association of PNI with PSA and Gleason score was assessed.

Serum level of PSA and Gleason core were significantly higher in patients with PNI (P< 0.001 for both). Gleason score was independently a predictor of PNI (odds ratio [OR]: 3.05, 95% CI:2.32- 4.001; P=0.001). Serum PSA level of 17 ng/mL had specificity of 90.3% and sensitivity of 42.7% for prediction of PNI.

In this study we found, Gleason score is independently a prognostic factor of PNI among cases undergone prostate biopsy. In addition, serum PSA level of 17 ng/mL was 90.3% specific and 42.7% sensitive for PNI occurrence. However, our findings require further evaluations by larger studies.