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Published in: World Journal of Surgical Oncology 1/2016

Open Access 01-12-2016 | Research

Prostate-specific antigen density values among patients with symptomatic prostatic enlargement in Nigeria

Authors: Emeka I. Udeh, Ikenna I. Nnabugwu, Francis O. Ozoemena, Fred O. Ugwumba, Adesina S. O. Aderibigbe, Samuel R. Ohayi, Kevin N. Echetabu

Published in: World Journal of Surgical Oncology | Issue 1/2016

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Abstract

Background

This study aims to estimate the prostate-specific antigen density (PSAD) cutoff level for detecting prostate cancer (CAP) in Nigerian men with “grey zone PSA” (4–10 ng/ml) and normal digital rectal examination findings. We addressed this research question: Is the international PSAD cutoff of 0.15 ideal for detecting CAP in our symptomatic patients with “grey zone PSA?”

Methods

Aim: To estimate the prostate-specific antigen density (PSAD) cutoff level for detecting CAP in Nigerian men with “grey zone PSA” (4–10 ng/ml) and normal digital rectal examination findings.
Design: Prospective.
Setting: A tertiary medical center in Enugu, Nigeria.
Participants: Two hundred and fifty-four men with either benign prostatic hyperplasia (BPH) or CAP were recruited.
Intervention: Patients with PSA above 4 ng/ml or abnormal digital rectal examination or hypoechoic lesion in the prostate were biopsied.
Outcome measures: PSAD and histology report of BPH or CAP.

Results

Ninety-seven patients had CAP while 157 had benign prostatic hyperplasia (BPH). Seventy-two patients had their serum PSA value within the range of 4.0 and 10 ng/ml. PSAD cutoff level to detect CAP was 0.04 (sensitivity 95.88 %; specificity 28.7 %).

Conclusions

The PSAD cutoff level generated for Nigerian men in this study is 0.04 which is relatively different from international consensus. This PSAD cutoff level has a positive correlation with histology and could detect patients with CAP who have “grey zone PSA.”
Literature
2.
go back to reference Eke NSMK. Prostate cancer in Portharcourt, Nigeria; features and outcomes. Niger J Surg Res. 2002;4:34–44.CrossRef Eke NSMK. Prostate cancer in Portharcourt, Nigeria; features and outcomes. Niger J Surg Res. 2002;4:34–44.CrossRef
3.
go back to reference Ezenwa ETK, Jeje A, Ogunjimi A, Ojewola R. Prevalence of prostate cancer among nigerians with intermediate total prostate specific antigen levels (4-10ng/Ml): experience at Lagos University Teaching Hospital, Nigeria. Internet J Urol. 2012;9:3. Ezenwa ETK, Jeje A, Ogunjimi A, Ojewola R. Prevalence of prostate cancer among nigerians with intermediate total prostate specific antigen levels (4-10ng/Ml): experience at Lagos University Teaching Hospital, Nigeria. Internet J Urol. 2012;9:3.
4.
go back to reference Gupta A, Aragaki C, Gotoh M, Masumori N, Ohshima S, Tsukamoto T, et al. Relationship between prostate specific antigen and indexes of prostate volume in Japanese men. J Urol. 2005;173(2):503–6.CrossRefPubMed Gupta A, Aragaki C, Gotoh M, Masumori N, Ohshima S, Tsukamoto T, et al. Relationship between prostate specific antigen and indexes of prostate volume in Japanese men. J Urol. 2005;173(2):503–6.CrossRefPubMed
5.
go back to reference Moul JW, Connelly RR, Mooneyham RM, Zhang W, Sesterhenn I, Mostofi F, et al. Racial differences in tumor volume and prostate specific antigen among radical prostatectomy patients. J Urol. 1999;162(2):394–7.CrossRefPubMed Moul JW, Connelly RR, Mooneyham RM, Zhang W, Sesterhenn I, Mostofi F, et al. Racial differences in tumor volume and prostate specific antigen among radical prostatectomy patients. J Urol. 1999;162(2):394–7.CrossRefPubMed
6.
go back to reference Basinet M, Meshref AW, Trudel C, Aronson S, Peloquin F, Nachabe M, et al. Prospective evaluation of prostate specific antigen density and systematic biopsies for early detection of prostatic carcinoma. Urology. 1994;43:44–51.CrossRef Basinet M, Meshref AW, Trudel C, Aronson S, Peloquin F, Nachabe M, et al. Prospective evaluation of prostate specific antigen density and systematic biopsies for early detection of prostatic carcinoma. Urology. 1994;43:44–51.CrossRef
7.
go back to reference Lujan M, Paez A, Llanes L, Miravalles E, Berenguer A. Prostate specific antigen density. Is there a role for this parameter when screening for prostate cancer? Prostate Cancer Prostatic Dis. 2001;4(3):146–9. Lujan M, Paez A, Llanes L, Miravalles E, Berenguer A. Prostate specific antigen density. Is there a role for this parameter when screening for prostate cancer? Prostate Cancer Prostatic Dis. 2001;4(3):146–9.
8.
go back to reference Guess HAHJ, Gormley GJ. The effect of finasteride on prostate-specific antigens in men with benign prostatic hyperplasia. Prostate. 1992;22(3):37. Guess HAHJ, Gormley GJ. The effect of finasteride on prostate-specific antigens in men with benign prostatic hyperplasia. Prostate. 1992;22(3):37.
9.
go back to reference Roehrborn CGBP, Nickel JC. Efficacy and safety of a dual inhibitor of 5 alpha-reductase types 1 and 2 (dutasteride) in men with benign prostatic hyperplasia. Urology. 2002;60:434–41.CrossRefPubMed Roehrborn CGBP, Nickel JC. Efficacy and safety of a dual inhibitor of 5 alpha-reductase types 1 and 2 (dutasteride) in men with benign prostatic hyperplasia. Urology. 2002;60:434–41.CrossRefPubMed
10.
go back to reference Araoye OM. Research methodology with statistics for health and social sciences. Illorin: Nathadex Publishers; 2003. Araoye OM. Research methodology with statistics for health and social sciences. Illorin: Nathadex Publishers; 2003.
11.
go back to reference Yeboah ED. The prostate gland. 3rd ed. Principles and practice of surgery including pathology in the tropics. Ghana: Ghana Publishing Corporation; 2000. Yeboah ED. The prostate gland. 3rd ed. Principles and practice of surgery including pathology in the tropics. Ghana: Ghana Publishing Corporation; 2000.
12.
go back to reference Benson M, Whang IS, Olsson C, McMahon D, Cooner W. The use of prostate specific antigen density to enhance the predictive value of intermediate levels of serum prostate specific antigen. J Urol. 1992;147(3 Pt 2):817–21.PubMed Benson M, Whang IS, Olsson C, McMahon D, Cooner W. The use of prostate specific antigen density to enhance the predictive value of intermediate levels of serum prostate specific antigen. J Urol. 1992;147(3 Pt 2):817–21.PubMed
13.
go back to reference Prassopoulos P, Charoulakis N, Anezinis P, Daskalopoulos G, Cranidis A, Gourtsoyiannis N. Suprapubic versus transrectal ultrasonography in assessing the volume of the prostate and the transition zone in patients with benign prostatic hyperplasia. Abdom Imaging. 1996;21(1):75–7.CrossRefPubMed Prassopoulos P, Charoulakis N, Anezinis P, Daskalopoulos G, Cranidis A, Gourtsoyiannis N. Suprapubic versus transrectal ultrasonography in assessing the volume of the prostate and the transition zone in patients with benign prostatic hyperplasia. Abdom Imaging. 1996;21(1):75–7.CrossRefPubMed
14.
go back to reference Watanabe T, Miyagawa I. New simple method of transabdominal ultrasound to assess the degree of benign prostatic obstruction: size and horizontal shape of the prostate. Int J Urol. 2002;9(4):204–9.CrossRefPubMed Watanabe T, Miyagawa I. New simple method of transabdominal ultrasound to assess the degree of benign prostatic obstruction: size and horizontal shape of the prostate. Int J Urol. 2002;9(4):204–9.CrossRefPubMed
15.
go back to reference Henneberry M, Carter MF, Neiman HL. Estimation of prostatic size by suprapubic ultrasonography. J Urol. 1979;121(5):615–6.PubMed Henneberry M, Carter MF, Neiman HL. Estimation of prostatic size by suprapubic ultrasonography. J Urol. 1979;121(5):615–6.PubMed
16.
go back to reference Ibinaye POAAO, Obajimi MO. Comparative evaluation of prostatic volume by transabdominal and transrectal ultrasonography in patients with prostatic hypertrophy in Ibadan. Eur J Sci Res. 2005;10:1–2. Ibinaye POAAO, Obajimi MO. Comparative evaluation of prostatic volume by transabdominal and transrectal ultrasonography in patients with prostatic hypertrophy in Ibadan. Eur J Sci Res. 2005;10:1–2.
17.
go back to reference Manieri C, Carter SS, Romano G, Trucchi A, Valenti M, Tubaro A. The diagnosis of bladder outlet obstruction in men by ultrasound measurement of bladder wall thickness. J Urol. 1998;159(3):761–5.CrossRefPubMed Manieri C, Carter SS, Romano G, Trucchi A, Valenti M, Tubaro A. The diagnosis of bladder outlet obstruction in men by ultrasound measurement of bladder wall thickness. J Urol. 1998;159(3):761–5.CrossRefPubMed
18.
19.
go back to reference Badmus TA, Asaleye CM, Badmus SA, Takure AO, Ibrahim MH, Arowolo OA. Benign prostate hyperplasia: average volume in southwestern Nigerians and correlation with anthropometrics. Niger Postgrad Med J. 2012;19(1):15–8.PubMed Badmus TA, Asaleye CM, Badmus SA, Takure AO, Ibrahim MH, Arowolo OA. Benign prostate hyperplasia: average volume in southwestern Nigerians and correlation with anthropometrics. Niger Postgrad Med J. 2012;19(1):15–8.PubMed
20.
go back to reference Nnabugwu II, Enivwenae OA, Amrasa AO, Okpara AL. Peri-operative blood transfusion in open suprapubic transvesical prostatectomy: relationship with prostate volume and serum total prostate specific aantigen (TPSA). Niger J Med. 2012;21(4):450–4.PubMed Nnabugwu II, Enivwenae OA, Amrasa AO, Okpara AL. Peri-operative blood transfusion in open suprapubic transvesical prostatectomy: relationship with prostate volume and serum total prostate specific aantigen (TPSA). Niger J Med. 2012;21(4):450–4.PubMed
21.
go back to reference Meng FJSA, Jin L, Young CY. The expression of a variant prostate-specific antigen in human prostate. Cancer Epidemiol Biomarkers Prev. 2002;11:305–9.PubMed Meng FJSA, Jin L, Young CY. The expression of a variant prostate-specific antigen in human prostate. Cancer Epidemiol Biomarkers Prev. 2002;11:305–9.PubMed
22.
go back to reference Stamey TA, Yang N, Hay AR, McNeal JE, Freiha FS, Redwine E. Prostate-specific antigen as a serum marker for adenocarcinoma of the prostate. N Engl J Med. 1987;317(15):909–16.CrossRefPubMed Stamey TA, Yang N, Hay AR, McNeal JE, Freiha FS, Redwine E. Prostate-specific antigen as a serum marker for adenocarcinoma of the prostate. N Engl J Med. 1987;317(15):909–16.CrossRefPubMed
23.
go back to reference Guess HA, Heyse JF, Gormley GJ. The effect of finasteride on prostate-specific antigen in men with benign prostatic hyperplasia. Prostate. 1993;22(1):31–37. Guess HA, Heyse JF, Gormley GJ. The effect of finasteride on prostate-specific antigen in men with benign prostatic hyperplasia. Prostate. 1993;22(1):31–37.
24.
go back to reference Arai Y, Maeda H, Ishitoya S, Okubo K, Okada T, Aoki Y. Prospective evaluation of prostate specific antigen density and systematic biopsy for detecting prostate cancer in Japanese patients with normal rectal examinations and intermediate prostate specific antigen levels. J Urol. 1997;158(3):861–4.CrossRefPubMed Arai Y, Maeda H, Ishitoya S, Okubo K, Okada T, Aoki Y. Prospective evaluation of prostate specific antigen density and systematic biopsy for detecting prostate cancer in Japanese patients with normal rectal examinations and intermediate prostate specific antigen levels. J Urol. 1997;158(3):861–4.CrossRefPubMed
25.
go back to reference Bazinet M, Meshref AW, Trudel C, Aronson S, Péloquin F, Nachabe M, et al. Prospective evaluation of prostate-specificantigen density and systematic biopsies for early detection of prosttic carcinoma. Urology. 1994;43(1):44–51.CrossRefPubMed Bazinet M, Meshref AW, Trudel C, Aronson S, Péloquin F, Nachabe M, et al. Prospective evaluation of prostate-specificantigen density and systematic biopsies for early detection of prosttic carcinoma. Urology. 1994;43(1):44–51.CrossRefPubMed
27.
go back to reference Sfoungaristos S, Katafigiotis I, Perimenis P. The role of PSA density to predict a pathological tumour upgrade between needle biopsy and radical prostatectomy for low risk clinical prostate cancer in the modified Gleason system era. Can Urol Assoc J. 2013;7(11-12):E722.CrossRefPubMedPubMedCentral Sfoungaristos S, Katafigiotis I, Perimenis P. The role of PSA density to predict a pathological tumour upgrade between needle biopsy and radical prostatectomy for low risk clinical prostate cancer in the modified Gleason system era. Can Urol Assoc J. 2013;7(11-12):E722.CrossRefPubMedPubMedCentral
Metadata
Title
Prostate-specific antigen density values among patients with symptomatic prostatic enlargement in Nigeria
Authors
Emeka I. Udeh
Ikenna I. Nnabugwu
Francis O. Ozoemena
Fred O. Ugwumba
Adesina S. O. Aderibigbe
Samuel R. Ohayi
Kevin N. Echetabu
Publication date
01-12-2016
Publisher
BioMed Central
Published in
World Journal of Surgical Oncology / Issue 1/2016
Electronic ISSN: 1477-7819
DOI
https://doi.org/10.1186/s12957-016-0921-6

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