Significance Of Prostate Specific Antigen And Prostate Volume In The Diagnosis Of Prostatic Diseases
Dr. Leo Francis Tauro Dept of General Surgery,Fr. Muller Medical College Hospital Kankanady,Mangaloreâ€“575002(D.K.),Karnataka.Ph.No:Hosp:(0824)2436301,Res:(0824)2224911,E-Mail:email@example.com
Background and Objectives: Prostate Specific Antigen (PSA) has been used as a screening tool for prostate cancer. Controversies exist with studies showing significant prostate cancer in men with normal PSA. The objective is to study the role of PSA in differentiating benign and malignant diseases of prostate and Prostate Specific Antigen Density (PSA-D) in prostate diseases.
Methods:This is a prospective study of data from 100 patients in our Medical College Hospital from July 2005-May 2007. All patients with lower urinary tract symptoms (LUTS), suggestive of prostate enlargement, were included. Patients with urethral strictures, calculi or with a previous history of surgeries and procedures on the prostate were excluded. All patients underwent digital rectal examination, serum PSA measurement and transrectal ultrasonography to measure prostate volume. Prostatic pathology was confirmed by biopsy in all patients after obtaining informed written consent.
Results:The mean age was 68.05 Â± 8.27 (SD) years. 40% of the patients had PSA values between 4-10ng/ml. There was no statistical correlation between age and PSA. Digital rectal examination had a sensitivity of 65.5% for detection of prostate cancer. Prostatic volume, as an independent variable, was not significant in predicting malignancy. Total PSA done in all cases was significant for the detection of cancer at levels >10ng/ml. PSA-D improved the sensitivity to detect malignancy.
Conclusion: PSA is significant in detecting prostate cancer at values >10ngm/ml. Prostate volume is not significant for diagnosis of prostatic diseases but PSA-D has a high sensitivity (96.55%) in detecting prostate cancer.