Clinicopathological Correlation of Prostatic Adenocarcinoma Lesions in Biopsy Specimens Seen in a Nigerian Tertiary Health Institution Located in North Central Region using Gleason Group Grading, PNI, LVI and Median PSA levels.

Background: Prostate cancer is one of the most prevalent malignancies among men worldwide and a major cause of morbidity and mortality. Histopathological grading and clinicopathological correlation play crucial roles in determining prognosis and guiding management. This study analyzed the histomorphological features of prostate carcinoma and their associations with clinical parameters, including PSA level, Gleason score, perineural invasion(PNI) and lymphovascular invasion(LVI). Materials and Methods: This retrospective descriptive study reviewed prostate biopsy specimens diagnosed as adenocarcinoma of the prostate at Jos University Teaching Hospital over a defined period. Patient demographics, clinical presentation, PSA levels, and histological grades were recorded. Histopathological evaluation included Gleason scoring and assessment of perineural and lymphovascular invasion. Data were analyzed to determine correlations between tumor grade, PSA levels, and other clinicopathological parameters. Results: A total of 377 cases of prostate malignancies were identified, accounting for 26% of all prostate biopsies. The majority of patients were aged 60 years and above. Prostatic Adenocarcinoma histologic subtype were 362 out of the 377 prostatic malignancies representing 96%. Mean PSA levels ranged from 3.0 ng/mL to 27 ng/mL, with a mean interval of 15 ng/mL. Most tumors with higher PSA levels correlated proportionally and directly with PNI & LVI with combined Gleason scores of 7 or higher, indicating moderately to poorly differentiated carcinoma. Perineural invasion was observed in 65% of cases with higher Gleason group grades while lymphovascular invasion was seen in 25% of cases with higher Gleason group grades. Further statistical analysis also revealed a positive correlation between PSA level and tumor grade. Conclusion Prostate adenocarcinoma demonstrates strong clinicopathological correlations, with Gleason grades ,PSA levels, PNI & LVI serving as reliable prognostic indicators. Therefore integration of histological grading with clinical data is essential for accurate risk stratification and patient management.