Correlation between prostate-specific antigen and bone scan findings in patients with prostate cancer at Grey’s Hospital, KwaZulu-Natal: A retrospective chart review (original) (raw)
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Prostate-specific antigen and risk of bone metastases in west Africans with prostate cancer
World Journal of Nuclear Medicine, 2019
We aimed to assess the relationship between bone scintigraphy findings and prostate-specific antigen (PSA) and Gleason score in a group of treatment naïve West Africans with prostate cancer. The age, PSA, and Gleason scores of 363 patients with prostate cancer were collected. Patients were risk stratified using the D'Amico criteria. Logistic regression was performed to assess the relationship between bone scan results and PSA and Gleason score. Receiver operating characteristics (ROC) analysis was used to determine the diagnostic reliability of the bone scan findings. Ninety of the 96 patients with metastases had high risk, and only 6 had low-to-intermediate risk disease (P = 0.0001). PSA (odds ratio [OR] 2.4 [95% confidence interval [CI] 1.5–3.8], P = 0.001) and GS (OR 2.2 [95% CI 1.5–3.1], P = 0.001) were independently predictive of the presence of metastases. ROC analysis revealed that PSA predicted the presence of metastases with an area under the curve of 0.72, and using a ...
International Journal of Clinical Urology, 2021
Prostate cancer is a leading cause of cancer death in men, second only to lung cancer. Bone metastasis is a common complication in prostate cancer patients that can cause bone pain and pathological fracture. PSA, Gleasons score, clinical T stage have been developed to integrate multiple clinical metastatic disease in prostate cancer patients. Bone radiography is used to rule out bone metastasis. It's common to have bone metastasis when PSA level is high and histology of poorly differentiated adenocarcinoma. Aim: To determine the prevalence of osteoblastic lesions and analyze the correlation of PSA levels, on lumbar sacral radiography in patients diagnosed with prostate cancer. Methods: This was a hospital based crosssectional retrospective study, conducted at KCMC urology institute from June 2108 to May 2019 and all prostate cancer patients diagnosed at KCMC during the study period both inpatients and outpatients attending urology department within the study period. The structural data sheet was used to collect information from patient file. Study parameters include Age, Gleason's score, PSA level used to assess the correlation with osteoblastic lesion on lumbar sacral x-ray. Results: A total of 97 patients included in the study, with mean age was 74.5 (SD) 8.97.6 yrs. Patients with Gleason score of 8-10 were 56 (57.8%) and the median PSA level was 126ng/mL with IQR (58.9-402.2) and The prevalence of bone metastases was 57.7%. There were 56 (49.5%) patient had osteoblastic lesions on lumbar sacral x-ray with PSA >100. Conclusion: The prevalence of bone metastasis is 57.7% with 49.5% of the patients had total serum PSA of >100ng/ mL. So lumbar sacral X ray can be used as a diagnostic tool when PSA is more than 100ng/ml. There is a need to avoid unnecessary lumbar sacral X rays in patients with carcinoma of the prostate who have no symptoms and sign metastatic disease and has PSA of less than 100ng/ml.
Jurnal Kedokteran Syiah Kuala, 2019
Background: Diseases primarily affects prostate gland are inflammation, hyperplasia, and malignant tumour. Gleason score (GS) is an essential facet and together with PSA are substantial in diagnosing, managing, and determining the prognosis of CaP. Purpose: The aims of this study is to investigate the prevalence of prostatic lesions and its PSA level among patients in anatomical pathology installation in RSUD Dr. Soetomo from year 2014 to 2016. Method: This research is a retrospective study of prostatic lesions that were conducted from year 2014 to 2016 (3 years) with emphasis on GS and PSA levels. Result: The distribution of histopathological lesion found are benign lesion, benign prostate hyperplasia, adenocarcinoma, prostatitis, benign prostate hyperplasia with prostatitis, prostatic intraepithelial neoplasia, non-Hodgkin lymphoma, sarcoma, transitional cell carcinoma, and squamous cell carcinoma. The most common findings in this cohort is benign lesion (34.6%) with age group of 61-70 years old (51.94%) and adenocarcinoma with high GS of 9 (60%). Meanwhile, patients with GS >8 (high risk patient) contributed for 84.8%. Most of the cases (69.2%) have elevated PSA level of > 20 ng/ml. Conclusion: The prevalence of prostatic lesions were able to be determined in different age groups. High GS indicates a more aggressive type of adenocarcinoma suffered, high risk for CaP. The results show that the possibility to detect malignancy with rising PSA level are higher, although PSA is not considered as a specific marker.
International Journal of Scientific Research, 2012
Total PSA (tPSA) has been used to diagnose prostate cancer although its performance as a screening test has several limitations including limited specificity. The main objective of the study was to determine the use of the PSA isoforms (free PSA, complex PSA and ratio of free/total PSA) in diagnosing prostate cancer among Zimbabwea men with tPSA levels between 3 and 10 ng/ml. A cross sectional study was done on 44 men attending a Urology Clinic at Harare Hospital (mean age = 70yrs). If tPSA was between 3 and 10ng/ml and the attending urologist requested a prostate biopsy a written consent was sought and the sample was analyzed for free and complexed PSA (cPSA). A follow up was made on the biopsy results. Statistical methods were then used to determine the use of the PSA isoforms (fPSA, cPSA and of f/tPSA ratio) in diagnosing prostate cancer. An increase in the fPSA significantly lowered the risk of developing prostate cancer (OR 0.01, p=0.003). However, the ratio of f/tPSA was more predictive of the occurrence of prostate cancer. Total PSA and cPSA were not significant (p=0.753 and 0.237 respectively). The ratio PSA test was highly predictive (AUC= 0.921, p=0.002) than free PSA (AUC=0.908, p=0.003). The study conforms to other reports postulating that f/ tPSA ratio can aid in the diagnosis of prostate cancer in the 3-10 ng/ml range as compared to the use of tPSA alone with f/tPSA ratio being more predictive. The use of cPSA remains uncertain. Not withstanding resource limitations, there is a need for larger national cohort studies which may run concurrently with CaP awareness campaigns.
African Journal of Urology, 2017
Introduction: In Western and Asian literature, the measurement of percentage free prostate specific antigen (%fPSA) has been known to enhance the predictive role of total prostate specific antigen (tPSA) in early prostate cancer (Ca-P) detection. Relationship between the tPSA and CaP are known to be influenced by race. To the best of our knowledge, the relationship between %fPSA and CaP has not been studied in sub-Saharan Africa using current established biopsy protocol. Objective: To evaluate the usefulness of %fPSA in indigenous West African men and determine the appropriate cutoff values that may be used as indication for prostate biopsy in men with tPSA of 4-10 ng/ml. Subjects and methods: A total 169 consecutive patients with tPSA of 4-10 ng/ml with non-suspicious findings on digital rectal examination (DRE) had a transrectal ultrasound (TRUS) guided 10-core prostate biopsy. The technique of PSA analysis was the Access hybritech assay technique using the Beckman's Access autoimmuno analyser. The rates of prostate cancer in different %fPSA ranges were evaluated. Receiver
Health, 2019
Introduction: Prostate cancer is gradually reaching a very high incidence in Africa, especially in the Sub-saharan region. Understanding the dynamics in occurrence of the disorder is one approach to developing effective public health programmes and interventions that will help curb the rising incidence. Objective: This study was aimed at reducing the paucity of data on prostate cancer by assessing the incidence, patterns and presentation in the Brong Ahafo Region of Ghana. We sought to provide region-specific hardcore data that will help to assess the issue and provide remedies. Method and Materials: All prostate disease cases recorded from the year 2009 to 2014 were retrospectively reviewed. Subjects from 40 years (based on previous studies) and above were eligible for screening. Diagnostic and screening tools for prostate cancer at the study site were family history, serum prostate specific antigen (PSA) test, digital rectal examination, urological ultrasound scan and histopathology (biopsy). Age, PSA values and year of screening/diagnosis were also retrieved from patient folders/archives for the purposes of the study. Histological findings and parameters considered in the study included diagnosis, carcinoma grading, perineural invasion (PNI) and percentage of affected tissues (%TA). Results: Prostate cancer constituted 236 cases (40.07%) of the 589 prostate diseases reviewed. The highest annual prevalence was recorded in 2014 with an incidence rate of 21.6% (51 cases). The ages of patients ranged from 46 to 101 years with a modal age range of 70-79 years and a mean ± SD of 71.7 ± 11.2. The mean PSA value recorded was 37.5 ng/ml (±68.9) with predominance in the 11-20.9 ng/ml (61 cases/patients) (27.9%) range. Moderately differentiated adenocarcinoma was the dominant grade of prostate cancer accounting for 61.4% (145 cases) of the 236 cases.
South African Medical Journal
Background. Prostate cancer (PCa) is the leading male neoplasm in South Africa (SA) and is the second most frequently diagnosed cancer among men globally. Age-specific incidence rates (ASIRs) vary by up to 189-fold globally, with an ASIR of 68.0 per 100 000 in 2018 in SA. Objectives. To describe PCa among men undergoing prostate biopsy in Gauteng Province, SA. Methods. We undertook a retrospective descriptive study using prostate biopsy data collected from the National Health Laboratory Service (NHLS) database between 2006 and 2016. We extracted the Systematized Nomenclature of Medicine (SNOMED) clinical terms morphology and topography codes to assign histological findings using the International Classification of Diseases for Oncology. PCa was defined as adenocarcinoma with a reported Gleason Score (GS). The new grade group (GG) based on the GS is defined as follows; (i) GG1 for a GS ≤6; (ii) GG2 for a GS of 3 + 4 = 7 ; (iii) GG3 for a GS of 4 + 3 = 7; (iv) GG4 for a GS of 8; and (v) GG5 for a GS ≥9. Higher-grade disease was defined as GG4 and GG5 (GS ≥8), in line with local guidelines. We reported associations of PCa with a GS ≥7 with age and race and used provincial and world standard population data to determine annual ASIRs. Results. We identified 22 937 biopsies referred to the NHLS between 2006 and 2016. Of the 6 448 biopsies (39%) with a PCa finding for black Africans, 46% were diagnosed with high-risk PCa compared with 36-40% for other race groups (p<0.0001). Black Africans were more likely than whites to have GG4 or GG5 PCa (odds ratio 1.45; 95% confidence interval 1.27-1.67). The ASIR increased from 44.9 per 100 000 in 2006 to 57.3 per 100 000 in 2016. Conclusions. Black African men were significantly more likely to present with PCa with a GS ≥8 (GG4 and GG5) compared with the other racial groups in Gauteng. The ASIR increased dramatically during the study period, perhaps as a result of increased screening and awareness. There is a need for additional research to better understand why black African men present with higher-grade disease.
African Journal of Urology, 2022
Background Globally, prostate cancer (PCa) is the commonest non-cutaneous male malignancy. It is more aggressive among black men with little known reasons as to the cause and continued trend among black men. This disproportionate pattern of PCa especially among black men of African ancestry resident in Africa calls for a closer look. Nigeria and South Africa, combined, have the highest cumulative risk incidence of PCa in Africa. The present study investigated the clinicopathologic behaviour of PCa among Nigerian and South African black men and the relationship between the disease and socio-demographic characteristics alongside medical co-morbidities. Methods A retrospective cross-sectional study was undertaken in which de-identified records of 234 black men with pathologically confirmed PCa between 2007 and 2017 from two tertiary hospitals, in Nigeria (National Hospital, Abuja) and South Africa (Tygerberg Hospital, Cape Town), were reviewed. Results Median age at presentation from b...
Introduction: Plasma levels of Prostate Specific Antigen (PSA) and total body bone scan findings play major role in diagnosis, treatment and monitoring of patients with cancer of the prostate. Although it has been suggested that total body bone scan (TBS) may not be necessary in prostate cancer patients with normal prostate specific antigen plasma level, controversy still exists. Aim: The study evaluates relationship between prostate specific antigen levels and Total Body Bone Scan findings in our prostate cancer patients and also to determine the PSA cutoff at which TBS is indicated. Methodology: This a retrospective review of the bone scan reports and the PSA levels of 101 prostate cancer patients at presentation in Radiotherapy Department of the University College Hospital, Ibadan, Nigeria. Results: Patients' PSA level ranges from 1.12ng/ml-837ng/ml. As the PSA increases, the rate of patients with positive TBS also increases at 3.