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Diagnosis of different pathohystological diseases of prostate in the most cases is based on common benignant and malignant characteristics. The presence of periacinar cleftings (PC) is an additional criterion favouring prostatic adenocarcinoma. According to the presence and extent of PC, analysed on high power field (400x), glands were classified into 3 groups: group 1-glands without PC or with PC affecting ≤50% of gland circumference; group 2-glands with PC affecting >50% gland circumference in <50% examined glands and group 3-glands with PC affecting >50% gland circumference in ≥50% examined glands. The aim of our study was to determine the importance of presence of PC in prostatic adenocarcinoma (ADCP) of Gleason score 7(3+4) and 7(4+3) and establish the existence of differences in their appearance at ADCP with first and second dominant histological grade 3 and 4 in each different relationship based on correlation analysis of PC and parameters of the predictive value (preoperative value of serum prostate specific antigen, tumor volume, clinical stage and degree of focal neuroendocrine differentiation). The study included 33 ADCP of Gleason score 7, 26 (78.79%) ADCP 7(3+4) and 7 (21.21%) ADCP 7(4+3). In ADCP Gleason 7(3+4) periacinar cleftings are more common in tumors that are smaller, better differentiated (produce more PSA), which is diagnosed in less advanced clinical stages and showing a less degree of focal neuroendocrine differentiation. In ADCP Gleason 7(4+3) periacinar cleftings are more common in tumors which produce less value of serum PSA (poorly differentiated) and in tumors that are diagnosed in advanced clinical stages. Periacinar cleftings are common findings in prostatic adenocarcinoma Gleason score 7(4+3) which are considerd as tumors with worse prognosis. Because of all we can rank PC among the important additional criteria for the diagnosis of adenocarcinoma of the prostate

praxis medica

Significance of periacinar cleftings as supporting criteria in diagnosis of prostatic adenocarcinoma Gleason score-a 7 (3+4) and Gleason score-a 7 (4+3) and their relationship with parameters of predictive value