Nava L.D.¹, Freschi M.², Doglioni C.², Scapaticci E.¹, Losa A.¹, Riva M.¹, Rigatti P.¹, Guazzoni G.¹

Presented on March, 22 2007

INTRODUCTION & OBJECTIVES: Aim of this study was to prospectively evaluate the efficacy and reproducibility of quickly processing prostate core needle biopsies with RHS1^®, an automated microwave- vacuum processor.

MATERIAL & METHODS: From July 2004 to July 2006 a total of 688 consecutive prostate biopsies were performed for Pca detection in men with PSA levels between 2.5 and 14 ng/ml. The biopsies (mean core number 20, range 14-24) were stretched between two sponges in tissue cassettes, fixed in formalin 4% solution, processed with RHS1^® (xylene-free), embedded in paraffin, cut at 3 μ and then stained with Hematoxylin-Eosin. Processing time, as well as time to final histological report, detection rate and percentage of further evaluations required were recorded; furthermore those results were prospectively compared with those registered in a concomitant series of 563 prostate biopsies performed in a similar series of patients, with the same sample technique, in the same period, but processed with the traditional method. Histopathological evaluations were performed by a single pathologist.

RESULTS: The overall detection rate for both groups (RHS1^® - processed biopsies vs. biopsies traditionally processed) was similar for both group, 39.7 % of Pca vs. 41%, 20% of HGPIN vs. 18.6% , 2% of ASAP vs. 3%. A comparable quality evaluation was given by the pathologist for both groups, confirmed at an intradepartmental review. No differences in core lengths were recorded pre- and post-processing.
The automatic processing time was 75 minutes vs. 14 hours, whereas the time to the definitive diagnosis was 190 minutes (range 145-260) vs. 24 hours. A quick diagnosis was performed in 661/688 pts (96%). In 27 pts additional immunohistochemical evaluations were successively performed without any modification of routinely used methods. All patients could conclude in the same day the diagnostic and staging process.

CONCLUSIONS: The two years experience confirms the validity of this new automated microwave- vacuum device to process in a short time prostate biopsies. RHS1^® resulted at least as effective as the traditional processing method and could guarantee a new time-effective standard to spare time, costs and stress for the patients. Being a xylene-free method, handling of the specimens is simplified and safer. RHS1^® allows a better quality of service with a one-day diagnosis.

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