Serum PSA level in Prostatic lesions with Histopathological correlation in Gujarat
Serum PSA level in Prostatic lesions
DOI:
https://doi.org/10.70284/njirm.v2i4.1937Keywords:
Benign prostatic hyperplasia, fPSA, prostate cancer, prostatic intraepithelial neoplasiaAbstract
Background: Prostate specific antigen (PSA) has been widely used in the diagnosis and management of patients with prostate cancer. It may be elevated in other prostatic diseases and surgical procedures. PSA exists in two forms, a major bound form (cPSA) and a free form (fPSA). Objectives: The objective of the study was to determine the relationship between serum fPSA levels and histologic findings in biopsy specimens of men with prostatic disease. Material and methods: This study includes 80 cases of prostatic diseases and 20 controls for the study were taken from the patients admitted in surgical wards with no prostate related complain, in different age were planned for transurethral resection of prostate (TURP). All the cases and controls were evaluated by serum prostate specific antigen level. Results: The median serum fPSA values for control, malignant and nonmalignant lesions were 3.66 ± 0.029 ng/ml, 20.33 ± 0.0106 ng/ml and 6.47 ± 0.8127 ng/ml respectively. Mean serum PSA values in cases of prostatic hyperplasia with or without dysplasia (PIN: Prostatic Intraepithelial Neoplasia I to III), prostatitis, well to moderately differentiated adenocarcinoma and poorly differentiated adenocarcinoma were 6.49 ng/ml, 5.35 ng/ml, 18.92 ng/ml and 31.6 ng/ml respectively. Cut off value of serum PSA 4 ng/ml the sensitivity, specifically and positive predictive value were 100 % and 14.28 % respectively while using 10 ng/ml the findings were 77.77 %, 92.95% and 58.33% respectively. Difference is highly significant between control cases and nonmalignant cases, (p < 0.001) as well as between nonmalignant cases and malignant cases (p < 0.001). Conclusions: In cases of prostatic hyperplasia, chronic prostatitis and prostatic malignancy serum fPSA value increases significantly (P < 0.001) above the standard (0 to 4 ng/ml) as compare to control and nonmalignant group. Statistically there is significant difference in serum fPSA values between control cases and non malignant cases as well between nonmalignant cases and malignant cases of prostate, but when serum PSA values are between 4.0 to10.0 ng/ml.
References
2. Wang MC, Valenzuela LA, Murphy GP. Purification of a human prostate specific antigen. J Invest Urol 1979:17;159-4.
3. Catalona WJ, Smith DS, Ratliff TL. Detection of organ confined prostate cancer is increased through prostate specific antigen based screening. JAMA 1973:270;948-6.
4. Chu TM, Wang MC, Lec CL. Enzyme markers for prostate cancer. Cancer detection and prevention.1929:2;693-13.
5. Mettlin CJ, Jones GW, Anerette H. Defining and updating the american cancer society guidelines for the cancer related check up. Prostate and endometrial cancer. C A cancer J. Clin 1993:43;42-4.
6. Tumours of the prostate. WHO. 1980.
7. Kasahara Y, Nakamura RM. Immunoassays and Immunochemistry in clinical diagnosis and management by Laboratory medoths, editor Hemmy JM, 19th edition. Prism Indian Edition 1994:851-25.
8. Bostwick DG, Amin MB. Prostate and seminal vesicles in Anderson’s Pathology, editor Damsanov Ivan, 10th edition. Published by Harcourt Bruce & Company. Asia, Mosby Philadelphia. 1995:2;2197-25.
9. Thomas AS, John EM. Adenocarcinoma of prostate in campbell’s Urology, 6th edition. Published by W. B. Saunders Company, Philadelphia. 1992:2;1159-1221.
10. Chodak G. Prostate cancer. To screen or not to screen ? Acta oncologica 1990: 19;285-2.
11. Muhittin AS, Ozkan O, Abdulah O, Bedrettin S, Seyfettin I, Adnan H et al. Diagnostic Approach to Prostate cancer using total Prostate specific antigen. Based parameter together. Annals of clinical & Laboratory science 2002:32;22-11.
12. Richardson TD, Osterling JE. Age specific reference ranges for serum prostate specific antigen. Urol clin North Am 1997:24;339-12.
13. Osterling JE, Jacobson SJ, Chute CG. Serum PSA in a community based population of healthy men. Establishment of age specific reference ranges. JAMA 1993:270;860-4.
14. Mehmet CU, Demokan, Cetinkaya M. The correlation between prostate specific antigen and age. Eur Urol 1997:32;416-3.15. Gil MJ, Allepuz C, Lioja LA. A multicenter study on the detection of prostate cancer by digital rectal examination and prostate specific antigen in the men with or without urinary symptoms. Eur Urol 1997:32;133-6.
16. Emokpae MA, Das SC, Torok, Mohmed AZ, Hassan AL. Early detection of prostate cancer evaluating the diagnostic performance of prostate specific antigen by comparing with histological technique among affricans. Indian J clin biochem 2004:19;62-4.
17. Bozemen CB, Carver BS, Eastham JA, Venable DD. Treatment of chronic prostatitis lowers serum prostate specific antigen. J Urol 2002:167;1723-6.
18. Simardi LH, Tobias MM, Kappaz GT, Taschner GP, Potts JM, Wroclawski ER. Influence of asymptomatic histologic prostatitis on serum prostate specific antigen. A prospective study. Urol 2004:64;1098-3.
19. Cooner WH. Prostate specific antigen, digital rectal examination and transrectal ultrasonic examination of the prostate cancer detection. Urol 1991:12;3.
20. Brawer MK, Chetner MP, Beatie J, Buchner DM, Vessella RL, Lange PH. Screening for prostate carcinoma with prostate specific antigen. J Urol 1992:147; 841-5.
21. Roger P, Breul J, Hartung R. Prostate specific antigen density and age specific prostate specific antigen value, The solution of prostate cancer screening ? J Urol 1997:125;287-5.
22. Amayo A, Obara W. Serum prostate specific antigen levels in men with benign prostatic hyperplasia and cancer of prostate. East Afr Med J 2004:81;22-6.
