Abstract
Prostate cancer is second leading cause of death in cancer related mortality after lung cancer i.e. mortality of prostate cancer is 6.6% and that of lung cancer is 23.6%. But 5 year prevalence of prostate cancer is highest i.e. 25.5. So Prostate cancer (PC) is an important medical and socio-economical problem due to its increasing incidence among the male populationand It is becoming an enormous health care burden and its early diagnosis is crucial for a successful treatment which ultimately will prolong and improve the quality of life. Widespread use of serum prostate specific antigen (PSA) level screening has dramatically increased the diagnosis of even small, early-stage prostate cancer lesions.
Aims: Role of serum PSA level in diagnosis of prostate cancer with its histopathological correlation.
Methods and Material: The study is a diagnostic cross-sectional study and Patients were informed about the nature and objective of the study and written informed consent was taken before recruiting them into the study after approval of the Institutional Ethics Committee.
Results: 1) Use of serum prostate specific antigen (PSA) level measurement increases the diagnostic accuracy of even small, early-stage prostate cancer lesions.
2) PSA level is a strong indicator of stage and prognosis.
Conclusions: The findings of study indicates that serial measurement of serum PSA level help in diagnosis of even small and early-stage prostate cancer. PSA level is indirect indicator of stage and prognosis of prostate cancer. Screening is advised in male population older than 50 years.
Keywords: prostate specific antigen, Prostate cancer, early diagnosis, screening
Key Messages: Screening male adults over 50 years of age with Prostatic specific antigen (PSA) can help diagnose prostate cancer early so as to prevent complications arising out of late diagnosis. Serum PSA is cost effective, easily available and non-invasive screening test.
References
1. Aaleshwaran KK, Mittal BR, Harisankar CN, Bhattacharya A, Singh SK, Mandal AK. Predictive value of serum prostate specific antigen in detecting bone metastasis in prostate cancer patients using bone scintigraphy. Indian J Nucl Med. 2012 Apr:81-84
2. Polascik TJ, Oesterling JE, Partin AW. Prostate specific antigen: a decade of discovery--what we have learned and where we are going. J Urol. 1999 Aug;162(2):293-306
3. Scardino PT, Weaver R, M'Liss AH. Early detection of prostate cancer. Human pathology. 1992 Mar 1;23(3):211-22.
4. Kleer E, Larson-Keller JJ, Zincke H, Oesterling JE. Ability of preoperative serum prostatespecific antigen value to predict pathologic stage and DNA ploidy Influence of clinical stage and tumor grade. Urology. 1993 Mar 31;41(3):207-16
5. Andriole GL, Crawford ED, Grubb III RL, Buys SS, Chia D, Church TR, Fouad MN, Gelmann EP, Kvale PA, Reding DJ, Weissfeld JL. Mortality results from a randomized prostate-cancer screening trial. New England Journal of Medicine. 2009 Mar 26;360(13):1310-9
6. Heidenreich A, Aus G, Bolla M, Joniau S, Matueeu V, Schmid HP, and Zatonni F. EUA guidelines on prostate cancer. European Urology 2008; 53(2): 260-72
7. Rieden T. Diffusion-weighted MRI in pro-state cancer detection: evaluation of its performance with pathohistological correl-ation. Eur. Congress of Radiology 2012.
8. Crawford ED, Thompson IM. Contro-versies regarding screening for prostate cancer. BJU Int Supp. 2007: 100:5-7
9. Berger AP, Deibl M, Strasak A, et al. Large-scale study of clinical impact of PSA velocity: long-term PSA kinetics as method of differentiating men with from those without prostate cancer. Urology. 2007 Jan: 69:134-38
10. Jesberger JA, Rafie N, Duerk J, et al. Model-free parameters from dynamic contrast-enhanced-MRI: Sensitivity to EES volume fraction and bolus timing. Journal of Magnetic Resonance Imaging. 2006: 24:586-94
11. Pinsky PF, Andriole G, Crawford ED, et al. Prostate-specific antigen velocity and prostate cancer gleason grade and stage. Cancer. 2007 Apr 15:109:1689-95
12. Boccon-Gibod L, Djavan WB, Hammerer P, et al. Management of prostate-specific antigen relapse in prostate cancer: a European Consensus. Int J Clin Pract. 2004 Apr: 58:382-90
13. Brawer MK. Prostate-specific antigen: current status. CA: a cancer journal for clinicians. 1999 Sep-Oct: 49:264-81
14. Freedland SJ, Kane CJ, Presti JC, Jr., et al. Comparison of preoperative prostate specific antigen density and prostate specific antigen for predicting recurrence after radical prostatectomy: results from the search data base. The Journal of urology. 2003 Mar: 169:969-73
15. Tosoian JJ, Trock BJ, Landis P, et al. Active surveillance program for prostate cancer: an update of the Johns Hopkins experience. J Clin Oncol. 2011 Jun 1: 29:2185-90
16. Stenman UH, Leinonen J, Alfthan H, Rannikko S, Tuhkanen K, Alfthan O. A complex between prostate-specific antigen and alpha 1- antichymotrypsin is the major form of prostate-specific antigen in serum of patients with prostatic cancer: assay of the complex improves clinical sensitivity for cancer. Cancer research. 1991 Jan 1: 51:222-26
17. Elabbady AA, Khedr MM. Free/total PSA ratio can help in the prediction of high gleason score prostate cancer in men with total serum prostate specific antigen (PSA) of 3-10 ng/ml. International urology and nephrology. 2006: 38:553-57
18. Catalona WJ, Smith DS, Ratliff TL, et al. Measurement of prostate specific antigen in serum as a screening test for prostate cancer. The New England journal of medicine. 1991 Apr 25: 324:1156-61