Home|Journals Follow on Twitter| Subscribe to List

Directory for Medical Articles
 

Open Access

Original Research

IJHRS. 2014; 3(3): 99-106


The Role of Serum Prostate Specific Antigen in Management of Prostatic Diseases A Biochemical, Pathological and Clinical Audit of its Present Status

Reshu Tewari, Swasti Sinha, Anurag Bajpai, Manisha Dwivedi, Shankar Madhav Natu, Divaker Dalela, Apul Goel.

Abstract
Background: Elevated serum levels of Prostate Specific Antigen (PSA) are used as a tumor marker in the detection of prostatic malignancy, in monitoring of wide spectra of prostatic diseases and in formulating various treatment plans of cancer. The use of PSA is a much debated issue in the international literature till date. Keeping the practical difficulties in mind often experienced by our clinicians, further comprehensive clinicopathological and biochemical studies are recommended to explore and utilize the full potential of PSA including its newer parameters especially tailored to suit the Indian population.

Objectives: To locate the cutoff of serum PSA for establishing differential diagnosis of prostatic diseases and its impact on the therapeutic plan and assess the prognostic significance in context of North Indian population.

Materials and Methods: All the participants (men above 50 years of age with Prostrate disease) were subjected to comprehensive Clinicoinvestigative work up. The previous clinical, radiological and pathologic findings were recorded in all patients on follow up for different prostatic diseases. Prostate biopsies and transurethral resection of prostate (TURP) specimens were procured wherever indicated and processed routinely.

Results: Total 232 cases of different prostatic diseases as categorized on the basis of clinical and histopathological diagnosis, including Chronic Prostatitis, Benign prostatic hyperplasia (BPH), Benign hyperplasia of prostate with Prostatitis, High grade Prostatitis Intra Epithelio Neoplasia (HG-PIN) and Prostatic Carcinoma. The expected cut off value for subsequent total PSA was found to be 9.42 ng/ml at 80% sensitivity. In our study postulating that total PSA level at 9.42 ng/ml the probability of detecting true carcinoma cases would be 93% and only 7% cases would be likely to be missed.

Conclusion: PSA levels have been shown to lose their diagnostic power to differentiate between different histological groups in high-risk category. Despite the low sensitivity of PSA, it continues to be an extremely powerful diagnostic test. This pilot study has revealed significantly higher values for different categories of Prostatic disease conditions.

Key words: Prostatitis, High grade Prostatitis Intra Epithelio Neoplasia (HG-PIN), Prostate Specific Antigen (PSA)



Share this Article


Advertisement
American Journal of Research in Medical Sciences

SUBMIT YOUR ARTICLE NOW


ScopeMed.com
BiblioMed Home
Follow ScopeMed on Twitter
Author Tools
eJPort Journal Hosting
About BiblioMed
License Information
Terms & Conditions
Privacy Policy
Contact Us

The articles in Bibliomed are open access articles licensed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License (https://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.
ScopeMed is a Database Service for Scientific Publications. Copyright ScopeMed Information Services.