Correlation between prostate volume and prostate-specific antigen in patients diagnosed with benign prostatic hyperplasia

Background: Prostate volume (PV) and serum prostate specific antigen (PSA) have been consistently linked to benign prostatic hyperplasia (BPH) disease progression especially when prostate volumes are >30mls and PSA>1.5ng/ml. PSA is produced by the ductal epithelial cells of the prostate. Understanding the natural history of prostate diseases requires knowledge of prostate volume and PSA. Objective: We set out to determine the correlation between prostate volume and PSA in our cohorts of men diagnosed with BPH. Methodology: Information from the case notes of 120 patients were retrieved including history, physical examination and result of relevant investigations. Data collated were analyzed using the statistical package for social sciences (SPSS) version 20.0 software. Results: Mean age of the patients was 64.95±9.22 years while mean PV and PSA were respectively 70.20±52.01mls and 4.58±3.32ng/ml. Correlation between PV and PSA was statistically significant: r=.407, P value was set at <.05. Conclusion: We concluded that PV and serum PSA levels have a direct relationship

Attitude, perceived risk and intention to screen for prostate cancer by adult men in Kasikeu Sub Location, Makueni County, Kenya

Background: Prostate cancer is increasingly becoming one of the most significant health problems facing Kenyan men and the commonest cause of cancer related death in men globally.Though increased survival rates occur when the diagnosis is done early, the disease is typically detected at a more advanced stage while participation in prostate cancer screening is extremely low. In addition, due to the aging population and population growth, the expected numbers will increase in forthcoming years. Thus, prevention and early detection has immense public health importance. Objective: This study assessed the attitude, perceived risk and intention to screen for prostate cancer by adult men in Kenya.Method: This study was conducted to identify factors associated with intention to be tested for prostate cancer risk among adult men in Kasikeu Sub location, Makueni County, Kenya. An analytical cross-sectional study design using quantitative methods was used.This was achieved through the use of Thomas Jefferson University Prostate Cancer Screening Survey questionnaire using face to face interviews. A sample of 155 men participated in the study and was selected using random selection. Screening for prostate specific antigen (PSA) within the next six months was done and explanatory variables namely attitude, social influence and perceived risk determine. Results: The sample population was aged between 25 to 94 years of age (mean 49.8, SD 16.7). The results indicated that all the men had heard of prostate cancer, but only 3.1% of the men had knowledge (causes and treatment); 2.4% had tested for prostate cancer, and 43.6 percent of the men intended to be tested in the next six months. There was no significant association between demographic factors such as marital status, religion, education level and screening intent (p>0.05). Variables that were significantly associated with intent to screen for cancer were attitude, social influence and perceived risk (p<0.05). Conclusion: There is need for increase health strategies to increase prostate cancer awareness, screening rates which are culturally sensitive and geared toward those living in rural areas with low education levels.In addition, health education should be geared toward modifying men's attitudes about PSA screening and target socially influential people in their lives especially the family. Recommendations: Qualitative studies could provide a more in depth understanding of perceived barriers to prostate cancer screening. This may provide health care professionals with the information they need to implement strategies to address these barriers, in order to increase prostate cancer screening in Kenyan men and ultimately decrease the rate of mortality from prostate cancer

Prostate cancer detected by screening in a semi urban community in Southeast Nigeria: Correlations and associations between anthropometric measurements and prostate-specific antigen

Context: Prostate cancer (PCa) is frequently diagnosed at advanced stages in Nigeria. Aims: To determine the screen detected PCa prevalence in a suburban community and explore any relationships between prostate-specific antigen (PSA) and anthropometric measurements. Settings and Design: Nsukka is a town and local government area (LGA) in Southeast Nigeria in Enugu State. Towns that share a common border with Nsukka are Edem Ani, Alor-uno, Opi, Orba, and Ede-Oballa. Nsukka LGA has an area of 1810 km2 and a population of 309,633 at the 2006 census. All consecutive responders who met the inclusion criteria were recruited. Subjects and Methods: A screening outreach was conducted in one location in Nsukka. PSA testing and digital rectal examinations were performed. Height and weight were measured and body mass index (BMI) was calculated. Statistical Analysis Used: Results were subjected to statistical analysis using SPSS 20 (IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY, USA). Categorical data were analyzed using the Chi-square test, with significance level set at P< 0.05. Pearson's correlation was conducted for interval data (P < 0.05). Results: One-hundred and sixty men met the inclusion criteria and were screened. Age range was 40­81 years; PSA range was 1.20­33.9 ng/ml. Digital rectal examinations (DREs) was abnormal in 17 men. Median BMI was 27.49. A Pearson's correlation coefficient showed a significant correlation between age and PSA, r = 0.127; P ≤ 0.05, and DRE findings and PSA, r = 0.178; P ≤ 0.05. There was no significant correlation between height and PSA, r = −0.99; P = 0.211; weight and PSA, r = −0. 81 P = 0.308; and BMI and PSA, r = −0.066; P = 0.407. 8/21 men consented to prostate biopsy with three positive, giving a screen detected PCa prevalence of 1.875%. Conclusions: Screen detected PCa prevalence in high this population and efforts to improve early detection may be of value in improving treatment outcomes

Cancer de la prostate : Corrélation entre le taux de PSA et le score de Gleason

Objectif : Evaluer la corrélation entre le taux de PSA et le score de Gleason. Patients et méthode : Il s'est agi d'une étude rétrospective où ont été retenus les malades ayant un diagnostic histologique de cancer de la prostate avec score de Gleason et un taux de PSA total initial. Trois groupes de différenciation ont été constitués. Le taux de PSA a été regroupé en six classes : < 10 ng/ml, [10-50 ng/ml], ]50-100 ng/ml], ]100-500 ng/ml], ]500-1000 ng/ml], >1000 ng/ml. Le test de Fisher et un modèle de régression logistique ont permis d'apprécier la corrélation entre le taux de PSA et le score de Gleason. Résultats : Soixante-deux cas ont répondu aux critères d'inclusion. L'âge moyen était de 66 ans (extrêmes 49-80 ans). Dans 83,9% le taux de PSA variait entre 10 et 500 ng/ml. Cinquante virgule cinq pour cent (50,5%) avait un score de Gleason compris entre 8-10. Les taux de PSA variaient entre 3 et 3025 ng/ml avec une médiane à 68,5 ng/ml, une moyenne à 211,37 ng/ml et un écart-type de 474,05 ng/ml. Le taux moyen de PSA était de 42,39 ng/ml pour les cancers bien différenciés, 222,8 ng/ml pour les cancers moyennement différenciés, et 249,09 ng/ml pour les cancers peu différenciés. La probabilité d'avoir un cancer bien différencié diminuait significativement avec l'augmentation du taux de PSA selon un rapport de cotes variant entre 1,46 et 1,82 (p = 0,029). Conclusion : Le taux de PSA pourrait permettre de prédire le grade de différenciation du cancer de la prostate mais pas le score de Gleason. Cette prédiction pourrait être améliorée en tenant compte du stade d'extension du cancer

The End of the Road for Prostate Specific Antigen Testing?

Many candidate biomarkers for diagnosis of prostate cancer have been investigated; but prostate-specific antigen (PSA) testing remains the frontline test for both mass screening and individual clinical testing. Although the PSA test is cost-effective; analytically reliable; and flexibly high throughput; it has a very weak correlation with prostate malignancy. This has resulted in over-diagnosis and over-treatment of patients leading to costly economic; social; and psychological impacts. PSA testing lacks the ability to molecularly characterize prostate diseases and define aggressiveness and lethality; which are necessary to influence choice of treatment. Therefore; newer molecular tests are beginning to replace the PSA tests. The prostate cancer antigen 3 test has shown superiority and is now widely used. The recently reported sarcosine urine test; the already delineated TMPRSS2: ETS fusion genes; the glutathione-S-transferase P1 serum marker; and enhancer of zeste homolog 2 biomarker may also help improve diagnosis and prognostication of prostate cancer. The analytical trend is toward a multiplex testing format using molecular and/or proteomic techniques that are reliable; accurate; reproducible; and ensure rapid quantitation. Therefore; validation of these newer biomarkers and their assays are necessary for both large-scale clinical trials and clinical utility

Detection of serum prostate specific antigen in lactating, pregnant, and advanced breast cancer Sudanese Women

Introduction: Although prostate-specific antigen (PSA) is the most valuable tumor marker for the diagnosis and management of prostate carcinoma; it is widely accepted that PSA is not prostate specific. Objectives: The aim of this study is to address the possibility of using the PSA as marker for the sex assignment in different categories and relevance of this test in women problems. Method: We have evaluated the measurement of serum total PSA for differentiation between Sudanese women with advanced breast cancer (n= 10); and those are lactating (n=10); pregnant (n=10) compared with 20 healthy women as control group. Serum total PSA (TPSA) was measured using immuno-radiometric assay (IRMA). Results: In this study the mean age was significantly higher advanced breast cancer groups compared with lactating group (P0.01). The mean serum PSA levels in the healthy control women examined (nsignificant high level of total PSA in serum of advanced breast cancer compared with the normal group (P 0.05). Conclusion: These results indicated the possible use of total PSA to distinguish between healthy women and/or women with advanced breast cancer

Prostate specific antigen versus digital rectal examination as screening for CA prostate in Sudanese patients

Objectives: The aim of this study is to compare the value of digital rectal examination (DRE) and prostate specific antigen (PSA) determination in the detection of prostate cancer among Sudanese patients presenting with lower urinary tract symptoms (LUTS). Material and Methods: A prospective study was carried out in Gezira Hospital for Renal Diseases and Surgery in the period of June 2003- May 2005. Patients presenting with LUTS, had been screened for prostate cancer using PSA and DRE examination.. Serum PSA and DRE were measured in all patients. Trans rectal biopsy was performed if the PSA was over 4ng and /or abnormal DRE. Results: A total of 194 elderly male pa3ents presen3ng with lower urinary tract symptoms (LUTS), 140 of them were at last diagnosed as benign prostate hyperplasia (BPH) and 54 pa3ents were been confirmed with prostate cancer (PCa). Their mean age was 65 years (range 45-90). Elevated level of PSA (> 4 ng/ml) was found in all the patients with prostate cancer (n= 54) and 68.6% (n= 96) of BPH patients. The rate of prostate cancer detection showed to be 25.7% for PSA > 4ng/ml, 13.31% for abnormal (positive) finding of DRE, and 27.8% for combination of the positive DRE and PSA > 4 ng/ml. The rate of BPH detec3on showed to be 68.6% for PSA > 4ng/ml, 28.6% for posi3ve finding of DRE, and 4.1% for combination of the positive DRE and PSA > 4 ng/ml. Conclusion: It was found that PSA determination detects a considerable proportion of tumors missed by DRE. And the combination of PSA and DRE escalates the probability of prostate cancer detection,

Prognostic Significance of Prostate-Specific Antigen (PSA) Rate of Change in Patients with Advanced Prostate Cancer

Aim: To investigate the prognostic significance of Prostate-Specific Antigen (PSA) rate of change in patients with advanced prostate cancer . Patients and Methods: A total of forty-nine male patients aged between 42 and 84 years with advanced prostate cancer receiving therapy of maximum androgen bloackade were enrolled and had their serum prostate specific antigen value and rate of change assessed over a period of 48 weeks. Results: The rate of change of prostate specific antigen at week 12 of the 40 patients with response (complete/partial) shows that the PSA level at week 12 had changed (reduced) by an average of 122 from the baseline value; while the median rate of change was 97 compared to patients with either no change/progression of disease status whose PSA level at week 12 had changed by only 11.7 and the median rate of change was 0. Conclusion: It could therefore be concluded that PSA rate of change is of prognostic significance in patients with advanced prostatic cancer

Serum transforming growth factor Beta1 and prostate specific antigen as markers for localized and metastatic prostate cancer

Objectives: To assess any additional benefits of the estimation of serum TGF Beta1 over serum PSA for differentiating localized from metastatic prostatic carcinoma. Patients and Methods: Forty-seven prostate cancer patients (23 with and 24 without metastases) and ten controls were included in the study. Serum PSA was estimated using the chemiluminescent immunometric assay; and serum TGF Beta1 was assessed using the enzyme immunoassay.Results: The mean serum PSA in the localized and metastatic disease groups were significantly higher than that in the control group (p0.001; p0.001 respectively); while the mean serum TGF Beta1 in the metastatic disease group only was significantly higher than in the control: group (p0.01). The mean serum PSA and TGF Beta1 in the metastatic disease group were significantly higher than the values in the localized disease group (p0.001; p0.001 respectively). Serum PSA was directly correlated with Gleason score in both patient groups (localized group: r

Can prostate cancer be predilected in BHP patients with elevated serum PSA negative initial sextant biopsy? A multivariate analysis study

Objective To define a predictor of prostate cancer in BPH patients with an intermediate PSA (4.1-10 ng/ml) and a negative initial sextant biopsy. Patients and Methods During 1999; 193 BPH patients with an intermediate PSA (4.1-10 ng/ml) underwent TRUS and sextant biopsy. The patients whose initial biopsies were negative for prostate cancer were re-evaluated by serum PSA every 6 months. A total of 76 patients were subjected to an extended 11-core biopsy in view of: (1) PSA velocity ? 1 ng/ml/year; (2) a PSA rise to 10 ng/ml and (3) suspicious biopsy findings (atypical adenomatous hyperplasia or high-grade prostatic intraepithelial neoplasia). Overall; 160 patients were subjected either to TURP (n=127) or open prostatectomy (n=33). Results On initial sextant biopsy; prostate cancer was diagnosed in 22 out of 193 patients (11.4). The specificity of the sextant biopsy was 91.8and its positive predictive value (PPV) was 61.1. A repeat 11-core biopsy revealed prostate cancer in 11 out of 76 patients (14.5). The specificity of the 11-core biopsy was 95.4and its PPV was 78.6. Three cancers out of 160 (2) were discovered on definitive pathology. The PSA velocity cut-off point at 1.4 ng/ml/year and the PSA density cut-off point at 0.12 were optimal for the prediction of cancer using receiver operating characteristic curves. The multivariate analysis (stepwise logistic regression) revealed that PSA density (p=0.011); PSA velocity (p=0.002) and age (p=0.021) were the most significant predictors of cancer when the data were inserted as a continuous format. The sensitivity; specificity and overall accuracy of the model were 80; 98.7and 95.9; respectively. When the data were re-inserted as a coded format; PSA velocity and PSA density were the only predictors. All the analyzed risk factors (age; PSA; DRE; prostate echogenicity and PSA/TZ index) were excluded from the model. Conclusion PSA velocity and PSA density were the most significant predictors of prostate cancer in BPH patients with an intermediate PSA (4.1-10 ng/ml) and a negative initial sextant biopsy