[Diagnostic possibilities of the prostate cytology, particularly considering the influence of the cytological degree of differentiation with the prostate carcinoma upon the 5 year survival rate (author's transl)].

Today, the transrectal fine-needle biopsy is firmly integrated in the establishment of the diagnosis of prostate carcinoma within the prophylactic examinations and as a check-up examination during the treatment of prostate carcinoma. Cytologically, the prostate carcinoma may be divided into four different degrees of malignancy: high-grade, medium-grade, low-differentiated and anaplastic carcinoma. Differential-diagnostically, chronic prostatitis may raise certain problems both clinically and cytologically. Electronmicroscopic examinations of samples taken by fine-needle biopsy are possible. Certain changes under anti-androgen treatment are examined at present. Under the contra-sexual treatment of the prostate carcinoma carrier there occur changes of the normal and carcinoma cells the extent of which permits conclusions as to the therapeutic hormone effect. This, in turn, results in consequences for the respective treatment. In 496 prostate carcinomata cytologically diagnosed since March 1970 the author was able to demonstrate that the 5 years' survival rate is determined by the cytological degree of differentiation. Whereas highly and medium-differentiated prostate carcinomata show an average 5 years' survival rate of 62.5 per cent, this amounts only to 33.9 per cent with the low-differentiated and anaplastic prostate carcinomata. The total 5 years' survival rate of all cytologically diagnosed carcinomata came up to 46.8 per cent. The 1-, 2-, 3-, 4- and 5 years' survival rate of all cytologically diagnosed prostate carcinoma carriers is almost in conformity with the values found by Esposti. The degree cytological differentiation in connection with the clinical stage clearly determines the clinical course with our patients.