Mean Prostate-specific Antigen Level Research Articles

Prostate cancer screening with Prostate-Specific Antigen (PSA) testing: A retrospective study

Objective: To evaluate the results of the prostate-specific antigen (PSA) test used in prostate cancer screening. Methods: This retrospective study was conducted on a total of 1106 male individuals, including 615 people (55.6%) aged 40-54, 379 people (34.3%) aged 55-69, and 112 individuals (10.1%) aged 70 and over. In the study, prostate-specific antigen (PSA) blood test results were performed on a total of 1106 male individuals aged 40 and over registered in the Uludag University Family Health Center, Bursa, Turkey during the 5-years between June 1, 2018, and May 31, 2023, were taken from the database and analyzed. Relationships with sociodemographic characteristics, comorbidities, and risk factors were examined. Data was analyzed using SPSS 25. Results: About 15.5% of the participants were married, 78.4% were single, and 6% were separated from their spouses or widows. The PSA values of the patients referred to the urologist were found to be significantly different between the ages of 55 and 69. It was determined that the PSA levels of the patients with benign prostatic hypertrophy and prostate cancer were higher than the patients without any finding, and the mean was 6.81±4.39 (p=0.01). Conclusion: In our study, it is important to diagnose benign prostatic hypertrophy or prostate cancer in patients aged 55-69 years, whose mean PSA levels were 6.81±4.39, and referred to a urologist. As a contribution to the discussions in the literature, we recommend that the patient with symptoms be referred to the urologist after the test request and the joint decision with the family physician. doi: https://doi.org/10.12669/pjms.40.10.8558 How to cite this: Goktas O. Prostate cancer screening with prostate-specific antigen (PSA) testing: A retrospective study. Pak J Med Sci. 2024;40(10):2324-2330. doi: https://doi.org/10.12669/pjms.40.10.8558 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

XRCC1 and XPD polymorphisms: clinical outcomes and risk of prostate cancer in Bangladeshi population.

In Bangladesh, only a fraction of prostate cancer patients are diagnosed annually due to lack of symptom awareness and screening challenges, resulting in high mortality. Aiming to improve screening methods, we evaluated X-ray cross-complementing gene 1 (XRCC1) Arg194Gln and Xeroderma pigmentosum group D (XPD) Lys751Gln polymorphisms to determine their relevance as potential markers for predicting prostate cancer risk, severity and clinical parameters in Bangladeshi population. This study included 132 prostate cancer patients and 135 healthy controls. Genotype analysis was done from blood samples by the PCR-RFLP method. The XRCC1 Trp/Trp genotype was associated with prostate cancer (ORadj = 5.51; 95% CI = 1.13-26.78; p-value = 0.03) compared to Arg/Arg genotype. No significant association was found between the XPD variants and prostate cancer risk. The XRCC1 Trp/Trp genotype increased prostate cancer risk in smokers and non-smokers but was statistically non-significant. In individuals without a family history of cancer, the XRCC1 Trp/Trp genotype had a non-significant 4.64-fold higher risk (ORadj=4.64; 95% CI = 0.88-24.36; p-value = 0.07), while the XPD Gln/Gln had a 2.66-fold non-significant higher risk (ORadj=2.66; 95% CI = 0.88-8.10; p-value = 0.09). The XRCC1 Trp/Trp variant was associated with hematuria risk, higher mean serum creatinine, and mean prostate-specific antigen (PSA) levels in prostate cancer patients. The XPD Gln/Gln variant was only associated with higher mean serum creatinine levels. Our findings suggest that XRCC1 screening may be used as a biomarker for prostate cancer to improve early diagnosis in Bangladesh.

Correlation between the Visual Prostate Symptom Score and International Prostate Symptom Score in Patients with Symptomatic Benign Prostatic Hyperplasia

Background: Benign prostatic hyperplasia affects about 210 million males as of 2010 (6% of the population). BPH is the most common disease of men above 50 years of age. BPH is a major cause of morbidity in the ageing men. Lower urinary tract symptoms, are a collective term for the symptoms of disrupted voiding in males, which has long been associated with BPH. Materials and Methods: Study was descriptive cross-sectional study conducted in Department of Urology, Nobel medical college, Biratnagar, Nepal over a period from January 2022 to December 2022. The entire Patient with visiting urology clinic of the provisionally diagnosed as BEP was enrolled in the study with approval of institutional review committee. Results: We enrolled a cohort of 75 patients who had been diagnosed with BEP. The mean age was 51.31 years. The mean prostate size among these individuals was measured to be 45.63 grams, and their mean Prostate-Specific Antigen level was determined to be 3.57.We observed a moderate positive correlation (r = 0.536) with statistical significance (p < 0.01) between VPSS total and IPSS total. Out of total, 35 (47%) completed VPSS alone without any assistance while filling IPSS only 9 (12%) could complete one. Median time for completing VPSS versus IPSS was 60sec and 300 sec respectively. Conclusion: In assessment of symptom severity visual prostate symptom score is equally effective as International prostate symptom score in cases of benign prostatic hyperplasia presenting with Lower urinary tract symptoms. All parameters of visual prostate symptom score is significantly correlated with International prostate symptom score.

Association of Prostate-Specific Antigen With Age, Digital Rectal Examination, and Lower Urinary Tract Symptoms in the Lebanese Population: A Cross-Sectional Study.

Prostate cancer (PCa) is a leading cause of mortality in men worldwide. Prostate-specific antigen (PSA) testing is a standard method for PCa detection, yet its associationwith age, digital rectal examination (DRE) results, and lower urinary tract symptoms (LUTS) remains understudied, particularly in the Lebanese population. This study aimed to investigate the associationof PSA levels with age, DRE results, and LUTS severity among Lebanese men. A total of 725 men aged 55-70 years were recruited from a men's health campaign at Saint George Hospital University Medical Center in Lebanon. PSA levels, DRE results, andInternational Prostate Symptom Score(IPSS)were assessed. Statistical analysis included Kruskal-Wallis tests and Spearman's rho correlation coefficient. Participants exhibited a significant correlation between age and PSA levels (r = 0.138, p < 0.01). PSA levels varied significantly across age groups (p = 0.029), with higher mean PSA levels observed in older age groups. IPSS status correlated positively with PSA levels (r = 0.23, p < 0.001), indicating higher PSA levels associated with increased LUTS severity. Abnormal DRE findings were significantly associated with elevated PSA levels (p < 0.00), suggesting their potential as an indicator of prostate abnormalities. This study highlights the importance of age-specific reference ranges for PSA levels in the Lebanese population. Elevated PSA levels were associated with older age, increased LUTS severity, and abnormal DRE findings. These findings highlight the significance of integrating PSA testing with clinical assessments for PCa detection and risk stratification in Lebanon.

A retrospective study of prostate-specific antigen and international prostate symptoms scores from participants at a men's health screening initiative in Trinidad.

This study describes the characteristics of men attending a primary health care screening initiative, determines the proportion of men who have elevated International Prostate Symptom Score (IPSS) scores and prostate-specific antigen (PSA) levels, and determines any correlation between these scores as indicators for benign prostatic hyperplasia (BPH) or prostate cancer. Data were collected from all patient records during men's health screening initiatives that occurred in December 2018, January 2019, and March 2019 in Trinidad and Tobago. A total of 350 medical records were analyzed to record patient demographics, PSA levels, and IPSS scores. Analysis of the data was performed with the use of Statistical Package for the Social Sciences software (version 27). Most men who attended the screening initiative belonged to the 61-65 age group (20.57%), with more than half of the men being married (57.71%) and employed (52.57%) and of patients with comorbidities (17%), the most prevalent included hypertension (6%) and diabetes mellitus (3.7%). A mean PSA level of 2.94 ng/ml and a mean IPSS of 7.62 were recorded. Moreover, 11.5% of the males had elevated PSA levels (>4 ng/ml) and 32.9% had elevated IPSS levels (>8). There were correlations between PSA and IPSS values (r = 0.161 and P = 0.006). Age was a predictor of both IPSS and PSA values (r = 0.214, P = 0.000 and r = 0.192, P = 0.000, respectively). Among diabetic participants, a small but significant correlation between IPSS and diabetes was shown (r = 0.223, P = 0.028). As a predictor of elevated IPSS, diabetes had an odds ratio of 1.132 (95% confidence interval (CI): 1.021-1.255). Our findings are similar to those described in previous studies; however, further investigations are required to fully describe the relationship between PSA and IPSS. This may assist in advancing screening measures and improving health outcomes for men with BPH and prostate cancer. Primary care physicians should recognize the possible association between BPH and diabetes mellitus and offer appropriate screening where indicated.

Tamsulosin 0.8 mg daily dose in management of BPH patients with failed tamsulosin 0.4 mg monotherapy and unfit for surgical intervention

AimThis study aims to evaluate the effectiveness and safety of administering double-dose tamsulosin (0.8 mg) for treating patients with benign prostatic hyperplasia (BPH) who have not responded to the standard single dose of tamsulosin (0.4 mg) and are deemed unsuitable for transurethral resection (TUR) intervention.Materials and methodsBetween November 2022 and July 2023, we prospectively analyzed 111 patients who were experiencing severe BPH symptoms. These patients received a double dose of tamsulosin for one month. We collected baseline characteristics such as age, body mass index, and underlying medical conditions. Various parameters including the International Prostate Symptom Score (IPSS), prostate-specific antigen (PSA) levels, prostate volume, peak urinary flow rate (Qmax), voided volume, and post-void residual volume were evaluated before and after treatment.ResultsAll 111 patients completed the study. The mean age, PSA level, and prostate volume were 63.12 ± 4.83 years, 3.42 ± 0.93 ng/ml, and 50.37 ± 19.23 ml, respectively. Of these patients, 93 showed improvement in Qmax, post-void residual volume, and IPSS score (p-value = 0.001). The total IPSS score and total Qmax improved from 24.03 ± 2.49 and 7.72 ± 1.64 ml/sec to 16.41 ± 3.84 and 12.08 ± 2.37 ml/sec, respectively.ConclusionDouble-dose 0.8mg tamsulosin as an alpha-blocker therapy appears to be a viable temporary management option for BPH patients who have not responded to the standard single dose 0.4mg tamsulosin and are not suitable candidates for TUR intervention.

Is the Serum Prostate-Specific Antigen Level Affected by Urethral Catheterization in Patients with Acute Urinary Retention?

Background: The reason for elevated serum prostate-specific antigen (PSA) levels in patients undergoing urethral catheterization due to acute urinary retention (AUR) remains a significant and controversial issue. Objectives: To assess the serum PSA level in men with AUR and its changes after catheterization. Methods: This prospective quasi-experimental study was conducted on 43 patients who underwent transurethral catheterization following AUR caused by benign prostatic hyperplasia (BPH). Total PSA levels and free/total PSA ratios were measured before catheterization and one and three days after catheter insertion. Additionally, prostate volume and urine output after catheterization (UOAC) were recorded. Results: The mean age, prostate volume, and UOAC of the patients were 69.05 ± 9.45 years, 60.51 ± 26.35 g, and 844.04 ± 341.66 mL, respectively. The mean and median baseline total PSA levels were 12.59 ± 17.71 ng/mL and 6.30 ng/mL, respectively. These values changed to 13.73 ± 19.83 ng/mL (median = 4.80 ng/mL) and 11.57 ± 17.70 ng/mL (median = 4.40 ng/mL) after 1 and 3 days of catheterization, respectively. The changes in total PSA and free/total PSA levels during the study period were not statistically significant (P &gt; 0.05). Moreover, the PSA levels showed no statistically significant difference before, 1 day, and 3 days after catheterization in groups with total PSA ≤ 4 and total PSA &gt; 4 (P = 0.37; 0.22, respectively). Conclusions: Our results suggest an initial elevation in PSA levels in patients with AUR before urethral catheterization. Both PSA and free/total PSA ratios showed no statistically significant differences before and after urethral catheter insertion, and initial PSA did not affect its changes after catheterization.

One-year Follow-up Results of Transperineal Biopsy For Patients Undergoing Irreversible Electroporation Treatment in Localized Prostate Cancer.

This article reports on the early results of a 1-year follow-up study investigating the efficacy of irreversible electroporation in the treatment of localized prostate cancer. The study included 18 out of 40 patients diagnosed with low- and intermediate-risk prostate cancer who underwent irreversible electroporation. Treatment results were evaluated through confirmation biopsies, comparing prostate-specific antigen levels, international prostate symptom scoring, and international index of erectile dysfunction scores before irreversible electroporation and at the 12-month mark. The mean age of the patients was 61.1 years (SD ±6.5). Out of the 18 patients, 16 were tumor free (88.8%), while 2 experienced recurrences, one within the treatment field and the other outside of it (P < .001). Irreversible electroporation significantly reduced mean prostate-specific antigen levels (6.73 ng/mL vs. 2.05 ng/mL, P < .001), indicating a 69.5% reduction within 12 months. Furthermore, there was a significant improvement in mean international prostate symptom scores at the 12-month followup (10.05 vs. 7.52, P=.003). The mean international index of erectile dysfunction scores before treatment was 19.17 (SD ±5.85), and after irreversible electroporation, it was 18.67 (SD ±6.34), with no statistically significant change (P=.065). The short-term oncological results of irreversible electroporation treatment are promising, particularly for patients in the low- and intermediate-risk groups. Additionally, irreversible electroporation does not negatively impact the international index of erectile dysfunction; however, it may lead to a decrease in international prostate symptom scores.

The feasibility of distance to the tumor of biopsy cores to estimate the extracapsular extension

BackgroundTo investigate the predictive capability of a new parameter, the distance between the fibromuscular capsule and the tumor as measured using a prostate biopsy core (referred to as “distance to the tumor” [DTT]), for the presence of extracapsular extension (ECE). Materials and methodsWe analyzed specimens obtained from 246 patients diagnosed with prostate cancer. All patients underwent prebiopsy, prostate magnetic resonance imaging (MRI), and subsequent prostatectomy. DTT measurements were obtained for each prostate biopsy core, and the minimum (min) DTT was extracted. We assessed the relationship between min DTT, MRI-estimated ECE, and pathological ECE, considering factors such as the PI-RADS score and tumor location. ResultsIn this study of 246 patients, the mean age was 65.8 years, and the mean prostate-specific antigen (PSA) level was 18.9 ng/ml. Patients with suspicious lesions in the peripheral zone and pathological ECE displayed higher rates of positive digital rectal examination (DRE), elevated PSA levels, and shorter DTT values in the biopsy cores. DTT demonstrated an accurate estimation of the presence of ECE, similar to MRI findings. Min DTT exhibited higher accuracy for peripheral zone masses, with a cutoff value of 1.0 mm for min DTT predicting ECE (AUC: 0.84, sensitivity: 72.23%, specificity: 77.78%, P < 0.01). Of the 246 patients, 66 had no ECE on MRI; however, 18 of these patients displayed pathological ECE, with 14 having DTT values <1.0 mm. ConclusionsMin DTT, positive DRE results, and a higher Gleason grade were significantly associated with ECE. DTT measurements of <1 mm can provide a more accurate prediction of ECE in the peripheral zone of the prostate than MRI-based assessments.

Evaluating the Oncological and Functional Outcomes in 167 Patients Undergoing Laparoscopic Radical Prostatectomy: Could Laparoscopy Still be a Viable Option in Suitable Patients?

Aim: To evaluate the oncological and functional outcomes of 167 patients who underwent laparoscopic radical prostatectomy (LRP). Materials and Methods: The retrospective study included 167 patients who were treated with LRP due to clinically localized prostate cancer between January 2007 and April 2012. Most of the patients were treated with the extraperitoneal approach. Preoperative evaluations included age, serum prostate-specific antigen (PSA) level, and biopsy Gleason score. Perioperative evaluations included duration of operative time and anastomosis time, blood loss (milliliter), and complications. Postoperative evaluations included length of hospital stay and catheterization time. Continence and erectile function were evaluated both pre- and postoperatively. The patients who used no pads or no more than one pad daily and the ones who had only a few urine leakages on effort or exertion were accepted as continent. Postoperative potency was defined as the ability to achieve sexual intercourse with or without the use of PDE-5 inhibitors. Results: Mean age and mean operative time were 62.4 ± 6.0 years and 220.5 ± 45.6 minutes, respectively. Mean anastomosis time was 35.6 ± 9.8 minutes. Mean serum PSA level and mean Gleason score were 17.5 ± 9.97 ng/mL and 6.16 ± 0.42, respectively. Pelvic lymphadenectomy was performed in 94 patients and nerve-sparing procedures in 61 patients. The pathological analysis revealed positive surgical margin in 35 patients (20.9%). Bilateral and unilateral nerve-sparing LRP procedures were performed in 51 (30.5%) and 10 (6%) patients, respectively. At 12 months after surgery, 3 (1.8%) patients were using 2 or more pads per day, 19 (26.4%) patients were satisfied with erection, hardness, and duration of intercourse, and 9 (12.5%) patients had an erection with insufficient hardness and duration. Conclusion: LRP is an acceptable method in localized prostate cancer due to its perioperative and early postoperative results.

Voice Analysis in Men with Benign Prostate Hyperplasia

Aim: In this study, we aimed to determine the differences by performing voice analysis in men with benign pros-tatic hyperplasia (BPH) and discussing it with the literature&#x0D; Methods: The study included 77 male patients who came to the urology outpatient clinic and were diagnosed with BPH and consult to us for voice analysis. Patients' ages, testosterone, prostate specific antigen (PSA) levels, prostate volumes (milliliters) were recorded. International prostate symptom scoring (IPSS) was applied to the patients. Mild, moderate, severe patients according to IPSS scoring; were classify as group 1, group 2, group 3, respectively. Voice Handicap Index-10 Turkish version (VHI-10) was realized to the patients and the results were saved.&#x0D; Results: 77 male patients were accepted to the study. The average age was 60. The mean prostate volume of the patients was 41.1 ml. The IPSS score of the patients was 16 on average. The mean VHI-10 scores were 9.14. The mean PSA levels of the patients were 1.43; testosterone levels were 3.04. F0 Hz (mean pitch) values were 157.74; jitter % values mean 0.26; shimmer % values mean 2.42; The mean HNR dB values were 22.91.&#x0D; Conclusions: Maybe it would be more logical to think that many local factors, hormones and growth factors are efficient in place of a testosterone.&#x0D; Keywords: Benign prostatic hyperplasia, voice, analysis, frequency

Association between body mass index and hemoglobin A1c with serum prostate-specific antigen level: A retrospective cohort study.

To assess the association between body mass index (BMI) and hemoglobin A1c (HbA1c) with serum prostate-specific antigen (PSA) level. A retrospective cohort study was carried out at King Faisal Specialist Hospital and Research Centre in Riyadh, Saudi Arabia, from January 2016 to December 2021. Data were collected from the medical records of patients who visited the family medicine clinics, including demographics, smoking status, BMI value, index PSA level, testosterone level, digital rectal exam findings, prostate biopsy status, fasting blood glucose (FBG), HbA1c, diabetes duration, chronic comorbidities (namely, hypertension, dyslipidemia, or chronic kidney disease), and medication history. The mean PSA level was 1.89±4.02 ng/dL and mean HbA1c was 6.59±2.69%. Of the participants, 41.8% were overweight, 54.3% were non-diabetics, and 85.3% were nonsmokers. Only 11 (1.6%) participants had undergone a prostate biopsy after taking a PSA test. There was a positive correlation between PSA level and age, a negative correlation between PSA level and BMI, and no correlation between PSA level and HbA1c or FBG. Prostate-specific antigen levels were higher in older people and those with low BMIs. No correlations were found between PSA levels and HbA1c or FBG, even after adjusting for other variables. Moreover, no correlations were found between PSA levels and other comorbidities such as dyslipidemia, chronic kidney disease, and hypertension.

Initial experience of laparoendoscopic single-site radical prostatectomy with a novel purpose-built robotic system

ObjectiveThis prospective single-arm clinical trial aimed to evaluated the feasibility and safety of the application of the SHURUI system (Beijing Surgerii Technology Co., Ltd., Beijing, China), a novel purpose-built robotic system, in single-port robotic radical prostatectomy. MethodsSixteen patients diagnosed with prostate cancer were prospectively enrolled in and underwent robotic radical prostatectomy from October 2021 to August 2022 by the SHURUI single-port robotic surgical system. The demographic and baseline data, surgical, oncological, and functional outcomes as well as follow-up data were recorded. ResultsThe mean operative time was 226.3 (standard deviation [SD] 52.0) min, and the mean console time was 183.4 (SD 48.3) min, with the mean estimated blood loss of 116.3 (SD 90.0) mL. The mean length of postoperative hospital stay was 4.50 (SD 0.97) days. Two patients had postoperative complications (Clavien-Dindo Grade II), and both patients improved after conservative treatment. All patients’ postoperative prostate-specific antigen levels decreased to below 0.2 ng/mL 1 month after discharge. The mean prostate-specific antigen level further decreased to a mean of 0.0219 (SD 0.0641) ng/mL 6 months after surgery. Thirty days postoperatively, 12 out of 16 patients reported using no more than one urinary pad per day, and all patients reported satisfactory urinary control without the need for pads 6 months after surgery. ConclusionThe SHURUI system is safe and feasible in performing radical prostatectomy via both transperitoneal and extraperitoneal approaches. Tumor control and urinary continence were satisfying for patients enrolled in. The next phase involves conducting a large-scale, multicenter randomized controlled trial to thoroughly assess the effectiveness and safety of the new technology in a broader population.

Therapeutic efficacy and safety results of 177Lu-PSMA therapy in metastatic castration-resistant prostate cancer patients: first experience of a developing South Asian Country.

Metastatic castration resistant-prostate cancer (mCRPC) is deadly condition that remains incurable despite various therapies. Initial studies have shown promising results with Lutetium-177 prostate-specific membrane antigen ( 177 Lu-PSMA) therapy for advanced prostate cancer. However, most of the published efficacy and safety data is retrospective. The purpose of the study was to prospectively evaluate the therapeutic efficacy and safety results of 177 Lu-PSMA therapy in mCRPC patients after 2 cycles. Twenty-five patients of mCRPC, treated with standard care treatment were enrolled for 2 cycles of 177 Lu-PSMA therapy. Prostate-specific antigen (PSA), Eastern Cooperative Oncology Group (ECOG) performance status, Visual Analogue Score (VAS) and Analgesic Quantification Scale (AQS) for efficacy and hemoglobin, total leukocyte, platelets and serum creatinine for toxicity were recorded pre and post-therapy. Paired sample t-test was used for statistical analysis. Treated patients with mean PSA level of 157 ng/ml received mean dose of 6.84 GBq of 177 Lu-PSMA. For PSA, partial response (PR) was seen in 11/25 (44%), stable disease (SD) in 8/25 (32%) and progressive disease (PD) in 6/25 (24%) patients. Grade 1 and 2 hemoglobin toxicity was seen in 5/25 (20%) and 6/25 (24%) patients respectively. No patient developed grade 3 or 4 bone marrow toxicities. Grade 1 and 2 nephrotoxicity was seen in 1 patient each. Statistically significant difference was seen in ECOG, VAS and AQS scores ( P < 0.001). No significant nephrotoxicity was observed ( P = 0.558). Efficacy and safety of 177 Lu-PSMA therapy after 2 cycles have shown significant PSA response and pain palliation in heavily pretreated mCRPC patients.

Standardised Uptake Value in Organ Confined Prostate Cancer in 68-Ga- Prostate-Specific Membrane Antigen Positron Emission Tomography-Computed Tomography Scan and its Correlation with Prostate Specific Antigen Level and Gleason Score.

A positron emission tomography (PET) scan and a computed tomography (CT) scan are an integral part of oncological imaging and other modalities such as magnetic resonance imaging, CT or bone scintigraphy have some limitations in staging the workup of prostate carcinoma. Combined with tissue-specific markers like prostate-specific membrane antigen (PSMA), positron emitter-based functional imaging results have improved. Our study aimed to determine the Standardised Uptake Value (SUVmax) in prostate adenocarcinoma that is confined to the organ in Ga-68-PSMA PET-CT scans and how it correlates with prostate-specific antigen (PSA) levels and Gleason score (GS). This cross-sectional study was conducted at Sindh Institute of Urology and Transplantation (SIUT), Karachi, and includes subjects referred for a Ga68-PSMA PET-CT scan from September 2017 to January 2022. Histopathologic-proven adenocarcinoma prostate patients with organ-confined disease and PSA levels obtained within 6 weeks before the PSMA-PET-CT scan were included in the study. PET-CT images were semi-quantitatively analysed by measuring SUVmax and the result was interpreted using statistical software SPSS version 22.0. A total of 154 patients were analysed. The mean age of patients was 66.57 ± 8.86 years. The GS of all patients ranges from 6 to 10. The mean and median PSA levels were 32.33 ng/mL (range: 0.004-306.00) and 14.20 ng/mL, respectively. The mean SUVmax of all prostatic lesions was 14.67 ± 12.58 and the median value was 10.76. SUVmax was higher in patients with a PSA level of more than ten than those with a <10. The correlation of SUVmax with PSA and GS showed a significant correlation. The SUVmax of organ-confined prostate cancer correlates well with PSA level and GS Median SUVmax and PSA directly relate to GS.

Prostate specific antigen-age volume score in predicting prostate cancer among the Indonesian population

Link of Video Abstract: https://youtu.be/ZNusQRjFEH0 Introduction: Several methods have been explored to increase the effectiveness of prostate-specific antigen (PSA) for prostate cancer screening. A lower prostate-specific antigen-age volume (PSA-AV) score is associated with higher cancer risk. This study aimed to evaluate the value of PSA-AV scores in the detection of prostate cancer among the Indonesian population. Methods: A retrospective study was conducted on 844 prostate biopsies performed at our center between January 2015 and December 2019. The score of PSA-AV was derived by multiplication of the patient's age and prostate volume and then division with PSA level. A ROC curve analysis was conducted to determine the cutoff for the PSA-AV score. The sensitivities and specificities of the PSA-AV score were contrasted with total PSA, PSA density, and age-adjusted PSA. Results: The mean age of the patient was 63.63±8.6 years, with a mean PSA of 16.3±13.9 ng/mL and a mean volume of 42.7±16.0 cm3. Among 844 biopsies, 25.5% tested positive for prostate cancer. Prostate cancer patients had significantly higher mean age, PSA levels, and positive digital rectal examinations (P&lt;0.05). In predicting prostate cancer, the PSA-AV score demonstrated a higher AUC of 0.772, surpassing the AUC of 0.762 achieved by the total PSA. The analysis identified a cutoff of 700 for the PSA-AV score, which showed significant sensitivity (94%) and sufficient specificity (8.4%). These values outperformed the total PSA cutoff of 4 ng/mL (sensitivity 91.6%; specificity 5.4%), PSA density cutoff of 0.15 (sensitivity 85.1%; specificity 30.0%), and age-adjusted PSA cutoff (sensitivity 88.4%; specificity 11.8%). The superiority of the PSA-AV score of &lt;700 was more prominent in the subgroup analysis of patients below 70 years of age and those with a low-moderate prostate volume (&lt;60 cm3). Conclusions: The PSA-AV score demonstrated superior sensitivities and specificities compared to total PSA, PSA density, and age-adjusted PSA. Therefore, it is recommended to utilize a PSA-AV score of &lt;700, particularly for men below 70 years of age with low-moderate prostate volumes (&lt; 60 cm3).

Diagnostic and Prognostic Role of Prostate-Specific Antigen Immunologic Staining in Prostate Cancer

Background: Prostatic adenocarcinoma is the second leading cause of death in males due to cancer. The prostate-specific antigen (PSA) serum level is the first marker for screening such patients. Objectives: The present study evaluated the comparison between the degree of staining of the PSA marker and some factors in the prognosis of prostate cancer. Methods: The current cross-sectional study was performed on 97 tissue blocks from patients with prostate adenocarcinoma collected in 2019 - 2020 from the Pathology Department of Golestan Ahvaz Hospital archives. Clinical information such as age, tumor size, grade of tumor, lymph node involvement, and vascular and perineural invasion was extracted from patients' pathology reports and recorded on a checklist. Then, PSA apical and intensity staining was studied using immunohistochemistry. Results: The mean age of patients was 72.76 ± 8.19 years. The mean serum PSA level was 39.2 ± 8.90. In the present study, the highest PSA staining intensity in the samples was related to grade 1 with a frequency of 39 (40.2%), and then it was related to grade 4 with a frequency of 38 (39.2%), while the lowest frequency of staining intensity was related to grade 2 was with a frequency of 9 (9.3%). Regarding PSA apical staining, 58 samples (59.8%) were positive, and 39 (40.2%) were negative. A statistically significant comparison was shown between Gleason scoring and PSA apical staining (P &lt; 0.001). The results indicate that increasing Gleason scoring decreases the staining intensity, and this correlation is significant (P &lt; 0.05). The mean age in samples with positive staining of apical marker PSA is lower than in samples with negative staining of apical marker PSA but is not statistically significant (P = 0.38). In contrast, the serum level of the PSA marker is statistically significantly higher in samples with positive staining of apical marker PSA than in samples with negative staining of PSA (P &lt; 0.001). According to the Spearman correlation coefficient test, the intensity of staining of the PSA marker decreases with age, and this correlation is significant (P = 0.032). However, according to the Spearman correlation coefficient test, staining intensity increases with increasing serum PSA level, and this correlation is statistically significant (P &lt; 0.001). Conclusions: It is also suggested that in future studies with a larger sample size, the comparison between apical marker expression and PSA marker staining intensity with clinicopathological factors, survival and mortality rates, response to treatment, etc., will be evaluated.

Correlation of multiparametric MRI with histopathological grade of peripheral zone prostate carcinoma.

Prostatic cancer is the second most common malignant tumor in men. Preoperative grading of prostate cancer is important for its management. Our objective is to compare individual and combined detection rates of T2-weighted imaging (T2WI), diffusion weighted imaging (DWI), dynamic contrast enhanced-magnetic resonance imaging (DCE-MRI), and magnetic resonance spectroscopy (MRS) for prostate cancer with histopathological diagnosis as its golden standard. Forty-four patients with positive digital rectal examination (DRE) findings and elevated prostate specific antigen (PSA), underwent multiparametric MRI (Mp-MRI). T2WI, DWI, DCE-MRI and MRS were done in all the patients. Cognitive magnetic resonance-transrectal ultrasound (MR-TRUS) fusion biopsy was done in all the patients. Sensitivity and specificity of T2WI, DWI, DCE-MRI, and Prostate Imaging - Reporting and Data System PIRADS version 2 was obtained. Apparent diffusion coefficient (ADC) value and choline/citrate ratio were obtained for each lesion and correlated with histopathological grade. The mean age of the patients was 68.7 ± 10.1 years, and the mean serum PSA level was 58.1 ± 22.4 ng/dL. Of the 38 lesions in peripheral zone, 33 (87%) had histopathologically proven prostate cancer. T2WI had a sensitivity and specificity of 75.8% and 80% and DWI had a sensitivity and specificity of 90.9% and 80%, respectively, for detection of malignant prostatic lesion. The mean ADC values for prostate cancer, prostatitis, and normal prostatic parenchyma were 0.702 ± 0.094 × 10-3 mm2/sec, 0.959 ± 0.171 × 10-3 mm2/sec, and 1.31 ± 0.223 × 10-3 mm2/sec, respectively. Type 3 curve has lower sensitivity (45.5%) but high specificity (80%) for diagnosing prostate cancer. DWI can be useful to differentiate benign from malignant prostatic lesions, and low-grade from high-grade prostate carcinoma. ADC value has a positive correlation with histopathological grade of prostate cancer.

Lower Urinary Tract Symptoms, Serum PSA, Digital Rectal Examination and Prostate Volume in Patients Presenting to Urology Department: A Cross-Sectional Study

Introduction: Lower urinary tract symptoms (LUTS) are common presentation in the urology department in males after 50 years. Enlarged prostate can be evaluated by digital rectal examination (DRE) and ultrasound. Serum prostate-specific antigen (PSA) has been suggested as a reliable tool to estimate prostate volume (PV) and to predict the diagnosis of prostate cancer. The aim of this study is to correlate prostate-specific antigen with clinical data like age and international prostate severity score (IPSS), DRE finding and PV among subjects with LUTS. Methods: Total of 175 cases were included in the cross-sectional study who presented with LUTS in the Urology Department. DRE was done and noted. Then the cases were advised for ultrasonography (USG) and serum PSA level was sent for investigation. According to the history given by the cases IPSS was done using the IPSS scoring questions. The result was obtained by grouping the cases according to the level of serum PSA Results: The mean age of the total 191 cases was 72.23±10.46 years and mean PSA level in our study population was 9.08±23.69 ng/ml. Grade III PV was seen among 47.1% of the study population. IPSS scoring between 8-19 was seen among 68.1% study population. Correlation between serum PSA and age group (p=0.007) was significant. High significance (p&lt;0.001) was seen in correlation between serum PSA and DRE finding, IPSS and PV. Conclusion: Our study showed that serum PSA level plays an important role in the evaluation of prostate enlargement. The level of serum PSA along with presenting symptoms and clinical findings can help us to plan our mode of treatment accordingly.

Detection of Androgen Receptor Gene Polymorphism in Sudanese Patients of Prostate Cancer in Khartoum State

Background: Prostate cancer (PCa) is the most commonly diagnosed solid tumor among men. Genetic susceptibility had been proposed among the risk factors for the development of this cancer.&#x0D; Aim: To investigate the effect of androgen receptor gene polymorphism in the susceptibility of prostate cancer among Sudanese patients.&#x0D; Methods: This study was conducted in Khartoum State during the period from December 2021 to May 2022. The study population that was selected consisted of one hundred patients, who had prostate cancer, who attended for routine follow-up assessment following their chemotherapy treatment. A total of 5 ml EDTA anti-coagulated venous blood samples were obtained from all participants. Prostate specific antigen (PSA) was measured by competitive chemiluminescence immunoassay. DNA extraction was performed for all samples by chemical method and genotyping was performed by PCR-RFLP method using Eco147I enzyme.&#x0D; Results: The Androgen receptor genotype showed that wild (G/G) type was more frequent (89%) than heterozygous (G/A) type (11%), and allele G was more frequent (94.5%) than allele A (5.5%). The mean serum PSA level among prostate cancer patients was 18.71+31.68 ng/ml. Comparison of the mean serum PSA levels between different AR genotypes revealed no significant association between the genotype and the hormonal level (p. values &gt; 0.05).&#x0D; Conclusion: Androgen receptor gene polymorphism was detected in this study population as heterozygous type. Moreover; there was no significant association between AR genotype and serum PSA level.