TOTAL PROSTATE SPECIFIC ANTIGEN LEVELS IN PROSTATE GLAND DISEASES SEEN IN LAGOS STATE UNIVERSITY TEACHING HOSPITAL, IKEJA (JANUARY 2010 – DECEMBER 2013)
Abstract
Background: Prostate gland diseases are worldwide ailments that have contributed immensely to the cause of morbidity and mortality among adult men. They are characterized by a raise in serum total prostate specific antigen (tPSA) levels which is being used over the years in detection and management of prostate cancer. Aim: The aim of this study was to determine the levels of serum total prostate specific antigen seen in patients with prostate gland diseases in Lagos State University Teaching Hospital (LASUTH), Ikeja. Materials and Methods:
The study was conducted in the Department of Pathology and Forensic Medicine, Lagos State
University Teaching Hospital, Ikeja. Some data were obtained from the patients’ case notes and
laboratory (Bola Tinibu Diagnostic Laboratory, LASUTH, Ikeja) registers. New slides that were made
in place of broken or missed ones were produced in the Department of Pathology and Forensic
Medicine, LASUTH. Results:
Two hundred and thirty study samples (cases) were analyzed in this study. The age range of all the
cases was 48-91 years with mean age of 67±7.3 years and a median of 66 years. BPH was the
commonest diagnosis with a relative frequency of 65.7%, followed by prostatic carcinoma (27.4%), prostatitis (5.2%) and then High grade prostate intraepithelial neoplasia (HGPIN) (1.7%). Cases with BPH and PCA had tPSA range of 2-84 ng/ml and 2-250 ng/ml respectively. Mean serum tPSA was found to be 16.0±12.0ng/ml, 66.4±54.0ng/ml, 15.4±6.7ng/ml and 2.0±0.8ng/ml in isolated BPH, PCA, Prostatitis and HGPIN respectively. All the benign cases as well as some malignant lesions had
serum tPSA levels ranging from 1.0ng/ml to 84.0ng/ml, while tPSA values of 85.0ng/ml and above
were seen only in malignant (prostatic carcinoma) cases. Correlation of serum tPSA with age and
Gleason score showed positive linear correlation of r=0.28 and r=0.25 respectively. Gleason score
category 5-7 (intermediate level) was the most common and it accounted for 50% while scores 2-4
were the least common.
Conclusion
BPH was the most common prostate gland disease followed by prostatic carcinoma, prostatitis and then HGPIN. Prostatitis co-existing with BPH and PCA were found to have higher tPSA than isolated prostatitis. Similarly, HGPIN co-existing with PCA had higher tPSA than isolated HGPIN. Serum tPSA correlated positively with age and Gleason score and also remains an important parameter in prostate cancer screening. Majority of adenocarcinoma cases in this study presented late in the hospital with poor outcome.
