Predicting Gleason score using the initial serum total prostate-specific antigen in Black men with symptomatic prostate adenocarcinoma in Nigeria

• Published in: Clinical interventions in aging 2016-01, Vol.11, p.961-966
• Main Authors: Nnabugwu, Ikenna I, Udeh, Emeka I, Ugwumba, Fredrick O, Ozoemena, Francis O
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - diagnostic imaging; Adenocarcinoma - pathology; African Continental Ancestry Group; Age; Age Factors; Aged; Aged, 80 and over; Antigens; Biopsy; Body mass index; Cancer therapies; Care and treatment; Diagnosis; Fisher's exact test; Gleason score; Humans; Keywords: PSA; Male; Medical screening; Middle Aged; Neoplasm Grading; Nigeria; Organ Size; Original Research; Pathology; Patient age; Patients; Prostate - pathology; Prostate adenocarcinoma; Prostate cancer; Prostate volume; Prostate-Specific Antigen - blood; Prostatic Neoplasms - diagnostic imaging; Prostatic Neoplasms - pathology; Retrospective Studies; Teaching hospitals; Ultrasonic imaging; Ultrasonography; Urology
• ISSN: 1178-1998; 1176-9092; 1178-1998
• DOI: 10.2147/CIA.S98232

Men of Black African descent are known to have the highest incidence of prostate cancer. The disease is also more aggressive in this group possibly due to biologically more aggressive tumor or late presentation. Currently, serum prostate-specific antigen (PSA) assay plays a significant role in making the diagnosis of prostate cancer. However, the obtained value of serum PSA may not directly relate with the Gleason score (GS), a measure of tumor aggression in prostate cancer. This study explores the relationship between serum total PSA at presentation (iPSA) and GS. The iPSA of patients with histologically confirmed prostate cancer was compared with the obtained GS of the prostate biopsy specimens. The age of the patients at presentation and the prostate volumes were also analyzed with respect to the iPSA and GS. The data were analyzed retrospectively using IBM SPSS Version 20. Pearson correlation was used for numeric variables, whereas Fisher's exact test was used for categorical variables. Significance was set at P≤0.05. There were 205 patients from January 2010 to November 2013 who satisfied the inclusion criteria. iPSA as well as age at presentation and prostate volume were not found to significantly correlate with the primary Gleason grade, the secondary Gleason grade, or the GS. However, the presence of distant metastasis was identified to significantly correlate positively with GS. GS may not be confidently predicted by the iPSA. Higher iPSA does not correlate with higher GS and vice versa.