The Cytologic Detection of Prostatic Carcinoma: Its Clinical Application

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Abstract
175 cytological studies were performed on the prostatic secretions of 150 men more than 50 yrs. old. Of 13 with proved carcinoma of the prostate, 4 had positive, 4 had suspicious, and 5 had negative prostatic secretions. 8 men had definitely positive prostatic secretions, 7 of which were proved malignant; in 1, biopsy revealed a granulomatous prostate. Routine cytological studies on prostatic secretions are advocated as a valuable adjunct in the early detection of prostatic carcinoma because (1) in early prostatic cancer, the gland often appears normal to palpation; (2) early cancer of the prostate is rarely diagnosed by transurethral biopsy; 3. punch biopsy through the perineum is unreliable; (4) open biopsy is a major operation in itself and frozen-section confirmation is often equivocal. Reliance on positive cytological studies should not be absolute, but each case should be evaluated in conjunction with other studies and examinations. The authors tentatively conclude that the presence of tumor cells in at least 2 prostatic secretion specimens is sufficient evidence of itself to warrant radical prostatectomy in cases in which the gland is palpably normal. In 2% of the entire series, adenocarcinoma of the prostate was discovered, and proved at operation, solely on the basis of positive prostatic secretions.

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