Abstract
Prostate cancer is the second commonest cancer in men worldwide. At present, every patient with lower urinary tract symptoms (LUTS) in St. Mary's Hospital Lacor is undergoing prostate biopsy regardless of the prostate specific antigen (PSA) level. We sought to determine the association between PSA and malignant prostate histology. This was a retrospective study. Data on age, PSA, prostate volume and prostate histology reported between Jan 2012 and Dec 2019 were retrieved from St. Mary's Hospital Lacor archive and analyzed using STATA SE/13.0. Records of 97 patients with LUTS was analyzed. The median (range) age of the patients was 71 (43-100) years. Median (range) of prostate volume was 91.8 (8.0-360.0) cc. Overall, PSA ranged from 0.21 to 399.2 ng/ml. Prostate histology showed 3.1% acinar adenocarcinoma, 24.7% adenocarcinoma and 72.2% benign prostatic hyperplasia. The median PSA amongst patients with malignant and non-malignant prostates were 15.8 ng/ml and 6.07 ng/ml respectively. Serum PSA level was significantly higher in patients with malignant prostate histology (Difference of mean= 9.7; p=0.001). Patients with LUTS and PSA levels of 15ng/ml or more were more likely to have malignant prostate histology.
Highlights
Prostate cancer is the second commonest cancer in men worldwide
Globally, prostate cancer was diagnosed in 7.1 % (1,276,106) of the world’s population and contributed to 3.8% (358,989) of all cancer deaths in 2018 and it’s the second commonest cancer diagnosed in men[1,2] The incidence of prostate cancer may be lower in low-middle income countries (LMIC) mortality has been on the rise 3
An abnormal prostate specific antigen (PSA) level was found in 72.2% (n=70) of the patients
Summary
Every patient with lower urinary tract symptoms (LUTS) in St. Mary’s Hospital Lacor is undergoing prostate biopsy regardless of the prostate specific antigen (PSA) level. PSA, prostate volume and prostate histology reported between Jan 2012 and Dec 2019 were retrieved from St. Mary’s Hospital Lacor archive and analyzed using STATA SE/13.0. Serum PSA level was significantly higher in patients with malignant prostate histology (Difference of mean= 9.7; p=0.001). Conclusion: Patients with LUTS and PSA levels of 15ng/ml or more were more likely to have malignant prostate histology. Evaluation for prostate biopsy by using Prostate health index has shown great help in determining men who don’t need prostate biopsy in comparison to other biomarkers at a sensitivity of 91% 13 as most often, prostate histology will show benign prostatic hyperplasia in 70 % of sample analysed 14. Scores of 6 or less describe cancer cells that look similar to normal cells and suggest the cancer is likely to grow slowly, score of 7 suggests an intermediate risk for aggressive cancer and scores of 8 or higher describes cancers that are likely to spread more rapidly, these cancers are poorly differentiated 16
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