Serum Prostate Specific Antigen and Mast Cells in Distinguishing Benign Prostatic Hyperplasia from Prostatic Carcinoma: Is there a Correlation?

Abstract

Introduction: Benign Hyperplasia of the Prostate (BHP) and prostate cancer comprise about 90% of all diseases of the prostate gland. An increase in serum Prostate Specific Antigen (PSA) is an indicator of underlying hyperplasia, inflammation, or cancer. Mast cells are found in both inflamed and tumour tissue. Aim: To find the correlation of mast cell count with age, weight of prostate, and serum PSA level, and thereby distinguishing between the benign or inflammatory prostatic enlargement against prostatic carcinoma. Materials and Methods: This cross-sectional observational study was conducted over a period of 18 months from November 2013 to April 2015 in a tertiary care hospital in West Bengal, India. Patients coming for treatment of enlarged prostate were included in this study as a convenience sample. Their age in years, weight of the gland by ultrasonography, serum PSA level, and mast cell count were recorded for analysis. The data between benign and malignant lesions were compared by the Mann-Whitney U test and the Spearman correlation coefficient was calculated to find correlation among the continuous variables. Chi-square test was done to compare categorical data. Microsoft Excel 2010 (Microsoft Inc, USA) and International Business Machines (IBM) Statistical Package for the Social Sciences (SPSS) Statistics 20.0 (IBM, New York, USA) software were used for conducting the statistical tests. Results: A total of 48 males with a median age of 63.5 years were studied. The weight of the prostate gland, serum PSA, and mast cell count were significantly higher in carcinoma of the gland. The weight of prostate gland (rs= 0.34, p-value= 0.02) and serum PSA (rs= 0.61, p-value <0.0001) was significantly positively correlated with mast cell count in overall sample. The PSA (p-value <0.001) significantly contributed to predicting the mast cells in linear regression. Conclusion: The serum level of PSA and mast cells were higher in carcinoma of the prostate. Higher prostate gland size and PSA would have higher mast cell infiltration. This study showed a correlation of serum PSA level with mast cell density, which may be used as an additional tool in distinguishing BHP versus prostatic carcinoma. Further studies are needed to find a more generalisable regression equation.