Relation of Prostate Specific Antigen and Histopathology of Prostate Biopsy.
DOI:
https://doi.org/10.15218/zjms.2010.018Keywords:
Prostate cancer, Prostate specific antigenAbstract
Background and objective: Prostate cancer is now the commonest cancer in men and the second commonest cause of cancer death after lung cancer. The introduction of pros-tate specific antigen (PSA) testing has revolutionized the early detection, management and follow-up of patients with prostate cancer and it is considered to be one of the best bio-chemical markers currently available in the field of oncology. This prospective study was aimed to Evaluate the diagnostic performance characteristics of prostate specific antigen (PSA) by comparing serum PSA value with histopathological finding of prostate biopsy , Determine the relation between PSA and various prostatic diseases, and To explain the effect of age on PSA testing.
Methods: To fulfill these objectives, 92 specimens of prostate biopsy from patients with history of prostatism who underwent prostate surgery (prostatectomy, TURP and true cut biopsy of prostate) with samples of serum for tPSA analysis taken preoperatively during a period of 10 months. In addition to 33 samples of serum taken from apparently healthy indi-viduals for tPSA analysis.
Results: From 92 cases 12 of them were malignant, 49 cases were BPH and 31 cases were BPH with prostatitis. Statistically there was significant relation between PSA values and histopathological findings of prostate biopsy and significant relation between age and PSA value of apparently healthy individuals. PSA sensitivity was (100%), specificity (46.25%), PPV (21.8%), and NPV (100 Sensitivity of PSA testing was better than specific-ity.
Conclusion: It is concluded that PSA evaluation is a sensitive marker for prostate can-cer but because of various other conditions that affect serum PSA concentration. Other methods of investigations such as DRE, TRUS and histological examination should be combined to confirm diagnosis.
Metrics
References
Yousef GM, Diamandis EP. The new human tis-sue kallikrein gene family: structure, function, and association to disease. Endocr Rev 2001; 22: 184- 204.
Lilja H, Christensson A, Dahlen U, et al. Prostate-specific antigen in serum occurs predominantly in complex with alpha 1-antichymotrypsin. Clin Chem 1991; 37:1618-1625.
Alexander EE, Qian J, Wollan PC, et al. Prostatic intraepithelial neoplasia does not appear to raise serum prostate-specific antigen concentration. Urology 1996; 47(5):693-698.
Thompson I, Carroll P, Coley C, et al. Prostate-Specific Antigen (PSA) Best Practice Policy. American Urological Association. Oncology 2000; 14:267-270.
Nash AF, Melezink I. The role of prostate specific antigen measurement in the detection and man-agement of prostate cancer. Endocrine-Related Cancer 2000; 7: 37-51.
Albertsen PC: Clinical Epidemiology: Incidence Rates, Databases, Age, and Co-Morbidity. In: Kantoff PW, Carroll PR, D'Amico AV, et al. Pros-tate Cancer: Principles & Practice, Philadelphia, Lippincot Williams&Wilkins, 2002:180-181.
Iraqi Cancer Board. Results of Iraqi Cancer Regis-try 1995-1997. Iraqi Cancer Registry Center, Min-istry of Health, 1999: 22-31.
Taha SA, Kamal BA. Screening program for pros-tate cancer at a university hospital in eastern Saudi Arabia. Saudi Med J 2005; 26(7): 1104-1106.
Mosli H.A.M. Prostate Cancer in Saudi Arabia: A review of the literature (1975-1996). Ann Saudi Med 1997; 17(5): 510-514.
Coley CM, Barry MJ, Fleming C, et al. Early de-tection of prostate cancer: I. Prior probability and effectiveness of tests. Ann Intern Med 1997; 126:394-406.
Balk SP, Ko YJ, Bubley GJ. Biology of Prostate–Specific Antigen. J clin Oncol 2003; 21 (2):383-391.
Presti JC: Neoplasms of the Prostate Gland. In: Tanagho EA, McAninch JW. Smith's General Urology. 15th ed, USA, Lange Medical Books McGraw-Hill, 2000: 399-416.
Brett TD. An analysis of digital rectal examination and serum prostate specific antigen in the early detection of prostate cancer in general practice. Family Practice Oxford University Press 1998; 15(6): 529-533.
Oesterling JE, Jacobsen SJ, Chute CG, et al. Serum prostate specific antigen in a community- based population of healthy men. Establishment of age-specific reference ranges. JAMA 1993; 270(7): 860-4.
Flamerz L.A.H. The role of TRU-CUT needle biopsy in detection of prostate cancer in compari-son to PSA, DRE & TRUS examinations. A thesis for the degree of Master of Science in Pathology, University of Sulaimany, 2006.
Mansoor IA. Pattern of Prostatic Diseases in Saudi Arabia. The Internet Journal of Pathology 2003; 2 -9).
Gohji K, Okamoto M, Morisue K, et al. Useful-ness of digital rectal examination, serum prostate specific antigen, transrectal ultrasonography and systematic prostate biopsy for the detection of organ-confined prostate cancer. Int J Urol 1995; 2(2):116-20.
George E, Thomas S: A Histopathologic Survey Of Prostate Diseases In The Sultanate Oman. The Internet Journal of Pathology 2005; 3(2): 1528-537.
Kehinde EO, Sheikh M, Mojimoniyi OA, et al. High serum prostate-specific antigen levels in the absence of prostate cancer in Middle-Eastern men: the clinician's dilemma. BJU International 2003; 91:618-622.
Mistry K, Cable G. Meta- analysis of prostate specific antigen and digital rectal examination as screening tests for prostate carcinoma. J Am Board Fam Pract 2003; 16(2):95-101.
Emokpae MA, Das SC, Orok T, et al. Early De-tection of Prostate Cancer: Evaluating the Diag-nostic Performance of Prostate Specific Antigen by Comparing with Histological Technique Among Africans. Indian Journal of Clinical Bio-chemistry 2004; 19(1): 62-66.
Hosseini SY, Moharramzadeh M, Ghadian AR, et al. Population-based screening for prostate can-cer by measuring total serum prostate-specific antigen in Iran. International Journal of Urology 2007; 14(5): 406-411.
Oesterling JE. Age- Specific Reference Ranges for Serum PSA. N Engl J Med 1996; 335(5): 345-346.
Babaian RJ, Johnston DA, Naccarato W, et al. The Incidence of Prostate Cancer in a Screening Population with a Serum Prostate Specific Anti-gen Between 2.5 and 4.0 ng /ml. Relation to Bi-opsy Strategy. Journal of Urology 2001; 165: 757-760.
Beardo P, Fernan Dez P, Corral J, et al. Unde-tectable Prostate Specific Antigen in Dissemi-nated Prostate Cancer. Journal of Urology 2001; 166: 993.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2010 Salah A. Abu baker, Payman Anwar Rashid (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The copyright on any article published in Zanco J Med Sci is retained by the author(s) in agreement with the Creative Commons Attribution Non-Commercial ShareAlike License (CC BY-NC-SA 4.0).