Histopathological correlations of serum prostate specific antigen (PSA) and tumor grade among prostate cancer patients in Kano, Nigeria

Context: Prostate cancer is the most common cancer in men of black extraction afflicting mostly the elderly with attendant morbidity and mortality. Prostate specific antigen (PSA) is the most widely used tumor marker for the diagnosis and management of prostate cancer. Patients with raised PSA above 4ng/dl need further evaluation by needle biopsy, and those with cancer are graded using Gleason's score for appropriate prognostication. Aims: The study was aimed at establishing a correlation between PSA level and Gleason's tumor grade among patients with prostate cancer. Settings and Design: This is a prospective study of prostatic needle biopsies and serum PSA of prostate cancer patients over a period of 1 year. Materials and Methods: Venous blood samples for serum PSA were taken and analyzed in the laboratory using an automated in vitro immunoassay analyzer. Patients with raised PSA values (>4 ng/ml) were counseled and consented for trans-rectal needle biopsies and sampled using an 18-gauge biopsy needle; tissue samples were routinely processed and reviewed. Statistical Analysis: Statistical analysis was performed by means of statistical package for social sciences (SPSS) software version 21. Results: The mean age of patients at presentation was 69 years with a range of 50 to 90 years and mean serum PSA of 78.8ng/dl. The dominant Gleason's scores were 7 and 8 with grade group 5 as the most predominant. There was however no significant correlation between serum PSA and tumor grade. Conclusions: Prostatic adenocarcinoma is associated with raised PSA, but tumor grade has no statistical correlation with PSA in patients seen at AKTH, Kano.