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Clinicopathological correlation of serum prostate specific antigen levels in patients of prostatomegaly in a tertiary care hospital

Vitesh Popli, Amit Rajan, Sonali Bose, Amit Kamewad.

Abstract
Background: In clinical practice, biopsies are generally performed only when the results of a prostate specific antigen (PSA) test or digital rectal examination (DRE) are abnormal. This leads to misdiagnosis of most small prostatic cancers present in many older men. Patients with lower urinary tract symptoms (LUTS) who have serum PSA levels higher than 4 ng/ml are primarily advised to undergo prostate biopsy to rule out cancer. However, PSA is organ specific but not cancer specific, so the presence of other prostate diseases such as benign prostatic hyperplasia (BPH), and prostatitis may influence its effectiveness for cancer detection. Hence, the PSA-based prostate cancer detection is fraught with high false-positive rate.

Objectives: The use of Serum PSA levels for the early detection of prostate cancer and evaluate its role with other modalities for diagnosis of prostate cancer and to diagnose different diseases of prostate, i.e., prostatitis, BPH in prostatomegaly, and its correlation with serum PSA levels.

Materials and Methods: This prospective descriptive study was conducted in Command Hospital (EC), Kolkata, West Bengal, India, in the period of June 2011 to June 2013. The patients were selected from the outdoor of Department of Urology and General Surgery. Institutional Ethical Committee Clearance and informed consent of all patients were obtained. 101 men at or >50 years of age presenting with LUTS specifically attributed to prostate problems were included in the study. Men with calcified or fibrotic prostate, with skeletal or distant metastasis or LUTS caused by any urological malignancy and who had previous prostatic surgery or pelvic radiotherapy or complications of urinary obstruction, were excluded from the study.

Results: A total of 101 male patients presenting with LUTS were included. Their mean age was 68.66 years. The majority, i.e., 49 (48.5%) of the study group were in the age group of 61-70 years. 52 (51.5%) of patients had serum PSA

Key words: Prostatomegaly; Lower Urinary Tract Symptoms; Benign Prostatic Hypertrophy; IPSS Score; Prostatic Cancer



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