Correlation between Total PSA Level and the Histoprognostic Gleason Score

Abstract

Prostate cancer is a public health problem in Senegal. It is one of the most common cancers in men and can be detected early by PSA measurement and confirmed by the pathological study which specifies the histological type and evaluates the histoprognostic scores (Gleason and pTNM). We did not find any anatomopathological study highlighting a link between the PSA t rate and histoprognostic Gleason scores in Senegal. Objective: We carried out this work aimed at determining whether there is a correlation between the PSA t rate and the histoprognostic Gleason score, in our context. Methodology: This is a retrospective, descriptive and analytical study conducted from January 2013 to October 2021, based on histologically proven prostate cancer cases with a specified PSA level, diagnosed in the pathological anatomy and cytology laboratory of Aristide Le Dantec hospital. Results: We identified 654 cases of prostate cancer. The average age was 68.59 ± 5.8 years with extremes of 40 years to 92 years. More than half of our cohort presented a clinical stage T2c, i.e. 56.94%. The average prostate volume on ultrasound was 81.81 ± 66 cc. The median PSA t was 110.5 ng/ml, with extremes ranging from 2 ng/ml to 74,770 ng/ml. Prostatic adenocarcinoma was the only histological type found in our patients. There was a predominance of Gleason score 6 (PICU grade group 1) observed in 35.17% of patients. Well-differentiated cancers were predominant and represented 35.17%. There was a statistically significant positive correlation between PSA t level and Gleason score (Spearman's Rho = 0.305, p = 0.000). Conclusion: This study shows that in the Senegalese population, in patients with prostate cancer, the higher the PSA t level rises above normal, the higher the Gleason score tends to be.