Relation of Prostate Specific Antigen and Histopathology of Prostate Biopsy

Abstract

Background and Objectives: 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.Conclusions: 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.