Study on correlation between PSA and various prostatic pathology

Abstract

Background: Prostate Specific Antigen (PSA) has been widely used in the diagnosis and management of patients with prostate cancer. It may be elevated in other prostatic diseases and surgical procedures. PSA exists in two forms, a major bound form (cPSA) and a free form (fPSA). Aims & Objective: The objective of the study was to determine the relationship between serum PSA levels and histologic findings in biopsy specimens of men with prostatic disease in Surendranagar district of Gujarat and to correlate morphological types. Materials and Methods: This study includes patients planned for transurethral resection of prostate (TURP). Blood samples were collected before TURP and tested for PSA. Histology of the tissue samples collected after TURP were studied and the relationship with PSA analysed using SPSS 12.0 Statistical software. The study pertains to utility of Prostate Specific Antigen Assay, in different Prostatic lesions e.g. Nodular Hyperplasia, Prostatitis and Carcinoma. Results: 655 patients were studied for PSA levels and simultaneous histopathological study of the biopsy samples has been done. There were 534 (81.53%) cases of Nodular Hyperplasia of Prostate (NHP, clinically known as ‘BPH’), 72 (10.99%) cases of Prostatic Intraepithelial Neoplasia (PIN), 45 (6.87%) cases of Adenocarcinoma of prostate. Serum PSA values were analyzed in different age groups (as 41- 50, 51-60, up to 91-100 years) and in different prostatic lesions like; NHP. PIN, Adenocarcinoma etc. Conclusion: PSA is specific for the prostate but not for prostate cancer. PSA is raised in cancer, prostatic infection, urinary retention & Nodular Prostatic Hyperplasia. There is urgent need of a more reliable and precise serum marker that reflects prostate cancer (in the current PSA range of 4 to 10 ng/mL).