Bone scan findings in a North African ethnic group and relation to PSA levels and Gleason score of the biopsy

Abstract

ObjectiveA number of large-scaled studies carried out in western countries have proven a positive relationship between serum prostate specific antigen (PSA) level and prevalence of positive bone scan findings, in newly diagnosed prostate cancer patients. The aim of our study is to verify that the tendency occurs as well in North-African population, as well as to establish a possible correlation between PSA level, bone scan result, and Gleason score. Material and methodsRecords of 348 patients diagnosed to have prostatic adenocarcinoma were reviewed retrospectively for bone scan results, PSA levels, and Gleason score. Statistical analyses were performed using the Fisher's exact test, by a statistical software (statistical package for the social sciences “SPSS”, version 11.5.1, Chicago, IL) with differences at P<0.05 considered significant. ResultsBased on positive bone scintigraphy 102 patients were proven to have bone metastases. None of these patients had a PSA level of lower than 10ng/ml. Six metastatic patients had PSA level between 11 and 20ng/ml. 45 metastatic cases had serum PSA between 21 and 100. Concerning PSA level over 101ng/ml, 51 men had positive bone scan. ConclusionBased on the PSA level, the likelihood of positive bone scan result can be postulated. According to PSA levels, staging investigations can be more selective for our patients. The risk of positive bone scan is so low that it is not required for patients with PSA level lower than 10ng/ml. On the other hand, on studying the correlation between Gleason score and PSA level or bone scan results, no statistically significant relationship was established.