Evaluation of prostatic cytology in primary diagnosis and clinical course of prostatic carcinoma.

Franzén's method of transrectal aspiration biopsy, capable of being performed without narcosis or hospitalization of the patient, is an ideal method of early recognition of prostatic carcinoma, and its reliability is equal to the more elaborate transrectal or transperineal needle biopsy. For the appraisal of the local therapy-effect, transrectal aspiration biopsy can be successfully used if no high-voltage radiation treatment of the primary tumour has been administered. For local progress-checks on radiologically treated prostatic carcinomas, however, needle biopsy with the Tru-Cut needle is clearly superior to aspiration biopsy. Cytologic and histologic progress-checks reveal that the local therapy-effect of the measures were applied were directly dependent on the primary degree of differentiation. No improvement in the therapy-effect is to be achieved by the use of high-voltage radiation, especially in cases of undifferentiated carcinoma of the prostate. The clinical course is also largely determined by the primary degree of differentiation, and 20 % of stage C patients tend, with or without radiation-treatment, to rapid metastasisation, although the local tumour may have partically disappeared after such treatment. The plasmatestosterone level could be related neither to the local therapy-effect nor to the clinical course, whereas the enzyme-status in numerous cases coincided with the clinical history, though not with the cytologically or histologically determined therapy-effect. We could not establish any radiologically induced typical therapy-effect on the prostatic carcinoma either by cytological or histologic means.