Efficacy of Prostate-Specific Antigen to Categorize Men with Prostate Pathology into Benign, Premalignant, and Malignant Lesions (original) (raw)
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DIAGNOSTIC UTILITY OF PROSTATE SPECIFIC ANTIGEN FOR DETECTION OF PROSTATIC LESIONS
Background: Carcinoma of prostate is one of the common tumors of old age in men. With digital rectal examination (DRE), prostate specific antigen (PSA) is a major screening tool for prostate cancer. The cutoff value for PSA of 4.0 ng/mL gives the highest sensitivity and highest specificity. Several modifications of PSA testing have been developed and may be beneficial for select populations. Methods: The study includes 180 cases between 48 to 76 years of age group. Serum PSA level and Histopathology of prostatic biopsy was done and correlate. Results: Widespread use of PSA for early detection prostate cancer in india. In present study 56% cases of BPH with mean age 57.77 ±4.86. and 33.1% Malignant (Adeno ca. + TCC) with mean age 65.70 ±5.64.
Histomorphologic Correlation of PSA Levels in Prostatic Pathology
National Journal of Laboratory Medicine, 2017
Introduction: Nodular Prostatic Hyperplasia (NPH) and carcinoma of the prostate are increasingly frequent with advancing age. Early detection of these lesions can significantly reduce the patient mortality and morbidity. Prostate Specific Antigen (PSA) level estimation has become a popular method for screening prostatic lesions as it is easy to perform and is cost effective. Aim: To evaluate the role of PSA as a screening tool in different prostatic pathology including prostate cancer. Also, to assess the accuracy of PSA at a cut off 4 ng/ml and to correlate Gleason's score with PSA levels. Materials and Methods: A total number of 170 prostatic biopsies from June 2012 to June 2016 received at the Central Diagnostic Laboratory, A.J Institute of Medical Sciences and Research Centre (AJIMS&RC), Mangaluru, India, was taken for the study. Paraffin embedded sections were stained with routine haematoxylin and eosin stain. The PSA levels were estimated in our Biochemistry Department. Th...
Correlation of serum PSA level with histomorphologic study in prostatic diseases
Indian Journal of Pathology and Oncology, 2018
Introduction: Worldwide, diseases of prostate gland are responsible for significant morbidity and mortality among adult males. Prostate cancer is the second common cause of cancer related death in men after lung cancer but it can be completely cured if detected in early stage. Aim: To evaluate the histomorphological spectrum of non-neoplastic and neoplastic lesions of prostate and to establish the correlation of histomorphological findings with serum prostate specific antigens levels. Materials and Methods: 1 year Prospective Study was done on 110 patient at Department of Pathology , Indira Gandhi Medical College, Shimla, H.P from 1 st July 14 to 30 th June 15. Unwilling patient, inadequate biopsies and patient with metastatic carcinoma to prostate were excluded from study. Paraffin embedded sections were stained with routine haematoxylin and eosin stain. The PSA levels were estimated in biochemistry department using automated Chemiluminescence method on Beckman Coulter Access-II System. These values were correlated with histopathological diagnosis. Result: With 63.3%, benign prostatic hyperplasia was the most common lesion followed by Malignancy in 29.1% and prostatic intraepithelial neoplasia in 7.3% of total cases. Serum prostate specific antigens level was increased in 65.5% cases. Mean serum prostate specific antigens value of benign prostatic hyperplasia with and without inflammation is and10.9ng/ml and9.8ng/ml respectively. Mean serum prostate specific antigens value is 18.9 ng/ml in Low Grade and78.5 ng/ml in high grade prostatic intraepithelial neoplasm. Mean serum prostate specific antigen in malignancy was 101.2ng/ml antigen in. Conclusion: On statistical analysis PSA is found to be a sensitive and early marker for the diagnosis of prostate cancer. With a cut off value of 4ng/ml sensitivity was found to be 93.75% and specificity was 46.15%.
Association of Serum PSA Levels with Histopathological Pattern of Prostate Lesions
Journal of Islamabad Medical & Dental College
Background: Pathological changes that mainly affect prostate gland are prostatitis, benign prostatic hyperplasia (BPH) and cancerous lesions. Digital rectal examination (DRE), Transrectal Ultrasonography (TUS), and prostate specific antigen (PSA) followed by histopathological examination, are routinely used tests for diagnosis of prostate lesions. The aim of the present study is to determine the role of serum PSA levels in differentially diagnosing the different types of prostate lesions.Material and Methods: This retrospective (observational) study was conducted in Ibn-e-Sina Hospital Multan. Data of 2189 patients who were operated from 2007 to 2017 due to prostatic lesions were included in this analysis. Patients with BPH, prostatitis, prostate carcinoma and Prostatic Intraepithelial Neoplasia (PIN) were grouped according to serum PSA levels (ranging from 0 to >100 ng/ml) into five groups. Frequencies and percentages were calculated for different histopathological findings. Ass...
2019
PURPOSE To evaluate the potential of prostate cancer detection on the basis of prostate-specific antigen (PSA)-level and percent free PSA (% fPSA) according to the outcome of prostate needle biopsy. METHODS This was a retrospective study of 1040 patients that underwent a prostate biopsy in the Urologic Clinic of the University Hospital of Ioannina, Greece. The patients underwent needle biopsy after abnormal finding in digital rectal examination (DRE). Tissue samples were extracted using a 12-core TRUS-GB. The patients were divided into four groups according to the biopsy outcome. Total serum and free PSA were measured. RESULTS The mean PSA concentration of cancer versus noncancer groups was significantly higher (p<0.05). The positive predictive value (PPV) of PSA for serum concentration >10 ng/ml was 47% while the negative predictive value (NPV) in patients with PSA levels <4 ng/ml was 81%. The diagnostic accuracy of % fPSA for patients with PSA level between 4-10 ng/ml was...
2016
Introduction: Prostate cancer is the fourth most common cancer in the men older than 50 years. It is in second place after lung cancer. Although the cause of prostate carcinoma has remained unknown, but clinical and experimental observations suggested the effective role of hormonal, genetic and environmental factors. Objectives: This study aimed to determine the relationship between total serum prostate-specific antigen (PSA) levels and free PSA to total PSA ratio with prostate cancer malignancy grade in biopsy specimens, and was performed according to Gleeson criteria. Materials and Methods: This study is a descriptive-analytical study. In patients with prostatic carcinoma the serum level of total PSA and free PSA were measured and according to the Gleason scoring system degree of malignancy was investigated. All data were analyzed by SPSS software. Results: A significant and direct relationship between free PSA/total PSA and Gleason score was found. Also, a significant correlation was observed between serum PSA level and the grade of the disease. Conclusion: Considering that prostatic carcinoma is one of cancers usually diagnosed late and since biopsy is hardly accepted by patients, with regard to the relationship between serum levels of free PSA and free PSA/total PSA ratio we can use serum level of free PSA and total PSA for diagnosis. Consequently, not only rapid and timely diagnosis of all types of cancer can have a positive impact on the healing process but also have particular effect in the treatment and reducing mortality established by this disease.
Indian Journal of Urology, 2014
Introduction: Introduction: Free to total prostate specifi c antigen ratio (f/t PSA) has been used to help improving specifi city of PSA in the range of 4-10 ng/ml based on the data on population based screening. There is no data on test characteristics of f/t PSA in men presenting with clinical symptoms of benign prostatic hyperplasia (BPH). This study is aimed to determine the usefulness of f/t PSA in symptomatic men. Methodology: Methodology: From January 2006 to June 2012, men of 50-75 years with lower urinary tract symptoms (LUTS), normal rectal examination and PSA between 4-20 ng/ml had free and total PSA assessment. Men with clinical evidence of prostatitis, retention, history of 5 blocker reductase inhibitors and those who had surgery or biopsy on the prostate in last 3 months were excluded. Receiver operating characteristic curves were derived for f/t PSA and total PSA. The effect of age, prostate volume and Gleason score on the f/t PSA was also analyzed. All statistical analyses were performed on SPSS 16 (Chicago, USA). Results: Results: Out of 170 men with the mean age of 67.4 ± 6.6 years, 43 (25.3%) had cancer on biopsy. Area under the curve for predicting the presence or absence of prostate cancer in all the men with f/t ratio was 0.63 (confi dence interval [CI]: 0.54-0.71). The median value of f/t PSA for men with cancer was 5.5% (1-25%) and 9.2% (1-63%) for those with no cancer. Cutoffs derived at 95% specifi city at PSA between 4-10 ng/ml and 4-20 ng/ml were 0.5% and 1% respectively. The specifi city of f/t PSA ratio at cutoff levels 7%, 10% and 15% was 73%, 60%, 45% for PSA range of 4-10 ng/ml and 63%, 47% and 35% for PSA range of 4-20 ng/ml PSA. Age, prostate volume and Gleason grade did not show any effect on f/t PSA. Conclusion: Conclusion: In men with LUTS the specifi city of various f/t PSA ratio cutoffs ; described for population based screening, is too low to be used as an aid to defer the decision of biopsy in PSA ranges of 4-20 ng/ml.
Introduction: Prostate cancer is the fourth most common cancer in the men older than 50 years. It is in second place after lung cancer. Although the cause of prostate carcinoma has remained unknown, but clinical and experimental observations suggested the effective role of hormonal, genetic and environmental factors. Objectives: This study aimed to determine the relationship between total serum prostate-specific antigen (PSA) levels and free PSA to total PSA ratio with prostate cancer malignancy grade in biopsy specimens, and was performed according to Gleeson criteria. Materials and Methods: This study is a descriptive-analytical study. In patients with prostatic carcinoma the serum level of total PSA and free PSA were measured and according to the Gleason scoring system degree of malignancy was investigated. All data were analyzed by SPSS software. Results: A significant and direct relationship between free PSA/total PSA and Gleason score was found. Also, a significant correlation was observed between serum PSA level and the grade of the disease. Conclusion: Considering that prostatic carcinoma is one of cancers usually diagnosed late and since biopsy is hardly accepted by patients, with regard to the relationship between serum levels of free PSA and free PSA/total PSA ratio we can use serum level of free PSA and total PSA for diagnosis. Consequently, not only rapid and timely diagnosis of all types of cancer can have a positive impact on the healing process but also have particular effect in the treatment and reducing mortality established by this disease.