Rajan Shah, Smriti Karki, Niharika Shah, Sushil Dhakal, Sudhir Kumar Singh, Rajendra Kumar Chaudhari
ABSTRACT
Introduction: Carcinoma of prostate is one of the common tumors of elderly men causing significant morbidity and mortality. Other prostatic pathology ranged from inflammatory lesions to benign prostatic hyperplasia (BPH). Screening programs with prostate-specific antigen (PSA) aimed at early detection of cancer is necessary. PSA is the most useful tumors marker in diagnosis and first-line test in screening. PSA, when combined with Gleason score, improves the prediction of pathological stage for prostate carcinoma.
Objective: The objective of this study was to investigate the relationship between serum PSA levels and histological finding in biopsy of men with prostatic disease.
Materials and Methods: A hospital-based descriptive cross-sectional study over a period of 1 year was carried out on biopsy specimen received at histopathology laboratory in the department of pathology. Histopathology slides were assessed and correlated with serum PSA level.
Results: Mean PSA value for BPH and prostatitis was 5.45 ± 7.109 and 5.77 ± 4.038, respectively. Prostatic adenocarcinoma was found in about 23.3% of total biopsy specimen. 16/20 cases (80%) of prostate adenocarcinoma have severe elevation of serum PSA level >20 ng/ml and majority of these cases were of high grade. Serum PSA in the range of 0–4 ng/ml was associated with benign lesions, and serum PSA more than 20 ng/ml was associated with malignant lesions (P <0.0001).
Conclusion: Serum PSA is elevated marginally in patients with BPH and active inflammation. Both benign and malignant pathologies can cause an increase in serum PSA levels, but the chances of finding malignancy increase with rising values of PSA.
Key words: Benign prostatic hyperplasia, prostate-specific antigen, prostatic adenocarcinoma