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

Authors Nnabugwu II, Udeh EI, Ugwumba FO, Ozoemena FO

Received 13 October 2015

Accepted for publication 31 December 2015

Published 18 July 2016 Volume 2016:11 Pages 961—966

DOI https://doi.org/10.2147/CIA.S98232

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Supriya Swarnkar

Peer reviewer comments 4

Editor who approved publication: Dr Richard Walker

Ikenna I Nnabugwu, Emeka I Udeh, Fredrick O Ugwumba, Francis O Ozoemena

Urology Unit, Department of Surgery, College of Medicine, Enugu Campus, University of Nigeria, Enugu, Nigeria

Background: 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.
Patients and methods: 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.
Results: 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.
Conclusion: GS may not be confidently predicted by the iPSA. Higher iPSA does not correlate with higher GS and vice versa.

Keywords: PSA, patient age, prostate volume, prostate adenocarcinoma, Gleason score

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Serum total prostate-specific antigen values in men with symptomatic prostate enlargement in Nigeria: role in clinical decision-making

Nnabugwu II, Ugwumba FO, Enivwenae OA, Udeh EI, Otene CO, Nnabugwu CA

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Published Date: 30 December 2014