PROSTATIC CARCINOMA

ASSOCIATION BETWEEN SERUM PROSTATIC SPECIFIC ANTIGEN (PSA) AND GLEASON GRADE

Abstract

Introduction: During the past many years the availability of serum PSA
as a screening marker, has encouraged its use to diagnose both prostatic cancer and its
recurrence. Patients with high S/PSA are at increased risk of advanced carcinoma prostate and
screening at an earlier stage would help to manage it accordingly. The aim of this study was
to determine association between serum prostatic specific antigen (PSA) levels and Gleason
grade in prostatic carcinoma patients. Study Design: Descriptive, case series study. Setting:
Department of Urology & Renal Transplantation in collaboration with Institutional laboratory
of Bahawal Victoria Hospital, Bahawalpur. Period: June 2012 to June 2014. Materials &
Methods: Total 160 patients of age 50-80 years with biopsy proven prostatic carcinoma were
included. Patients with h/o radiotherapy for prostatic carcinoma and anti-androgen therapy
were excluded. Histological slides of each patient were reviewed by using the Gleason grading
system. Gleason grade of each patient was correlated with his serum prostatic specific antigen
(PSA) report which was done before surgery or biopsy. Results: In our study, mean age was
66.89 ± 9.28 years. Mean serum PSA was 21.41 ± 13.67 ng/ml. Intermediate grade cancer
was found in 38.75% patients followed by moderate to poorly differentiated cancer in 31.86%
patients. Gleason score ≥7 was significantly higher in patients with serum PSA >20 ng/mL than
those with serum PSA ≤ 20 ng/mL (p-value of 0.000). So, serum PSA was positively correlated
with gleason grade (OR = 3.67, Cl = 95%, P = 0.0001) Conclusion: This study concluded
that there is statistically significant association between serum prostatic specific antigen (PSA)
levels and Gleason grade in prostatic carcinoma patients and patients with high prostate
specific antigen are at increased risk of advanced carcinoma prostate.