Early detection of prostatic carcinoma using t- PSA

Abstract

The study attempt to elucidate the performance of serum prostate specific antigen (PSA)as a diagnostic tool for prostate cancer in a selected group of patients. Serum level of total PSA (t-PSA) was measured. The study sample was composed of 180 male patients with lower urinarytract symptoms, abnormal digital rectal examination and abnormal trans-rectal ultrasound. Thepatients were divided according to the histopathological findings of the excised tumor into 2groups: Group (1): Patients with prostate carcinoma (PCa) includes 38 (21.1%) patients,Group (2): Patients with nodular benign hypertrophy of the prostate (NBHP) includes 142 (78.8%)patients, and Control Group (3): Includes 50 apparently healthy male without lowerurinary tract Symptoms. A total PSA were measured in the serum before the patients do theoperative excision of prostatic carcinoma in Al-Zahrawi Teaching Hospital in Mosul. Acomparison among the three groups revealed a significant difference in serum t-PSA betweengroup 1 (PCa) and group 3 (control) and between group 1 (PCa) and group 2 (NBHP) (P < 0.01)with higher serum t-PSA mean values in group 1 (PCa) whereas a nonsignificant differencebetween group 2 (NPHP) and group 3 (control), (P > 05). Validity parameters of the serum totalPSA were calculated at different cut-off values. At a cut-off value of 7 ng/ml, the sensitivity,specificity, positive predictive value, negative predictive value, accuracy rate, positive likelihoodratio, and negative likelihood ratio were 89%, 94%, 54%, 97%, 93%, 17.8%, and 9.4%respectively.Key words: prostate specific antigen, prostate cancer.