Relation of Age and Serum Prostatic-Specific Antigen level with Histopathological diagnosis in Transurethral Resection of Prostate specimen, an Experience from Eastern Tertiary Hospital

Abstract

Background: Prostatic Specific Antigen (PSA) is a protease secreted by epithelial cells of prostate. Serum PSA level is increased when the normal structure of gland is destroyed by benign or malignant tumor or inflammation. Though there is established relation between PSA plasma level and age among the two most common prostate diseases (Benign prostatic hyperplasia and Carcinoma Prostate) in the literature, relation has not been explored in our part of the world, therefore, this study was done to see the relation between age and PSA amount with Prostate diseases.
 Material and Methods: This was a Cross-sectional study conducted in a tertiary hospital, Nobel Medical College Teaching Hospital from January 2017 to December 2018. Ethical clearance was obtained from Institutional Review Committee (IRC). All the cases of prostate diseases presenting to urology department undergoing transurethral resection of the prostate (TURP) were included. Histopathology report of TURP specimen were collected from department of pathology and the relationship between diagnosis, PSA level and age were established.
 Results: BPH was the most common diagnosis (72.41%). Age of BPH patients ranged from 48-78 years and mean age with SD was 60.56±7.32. Median age with interquartile range was 61.00. Similarly, in the BPH group, PSA value ranged between 0.80-15.40 ng/ml with mean PSA value along with SD being 5.64±4.16 ng/ml. Similarly, Median PSA value with interquartile range was 4.20ng/ml. Carcinoma Prostate (27.59%) was the second most common diagnosis. Histological type of all cases diagnosed as cancer was adenocarcinoma. Their age ranged between 54-83. Their mean age with SD was 67.67±7.68. Similarly, Median age with interquartile range was 68.00. PSA value in this group ranged between 8.50-147.30 ng/ml. Again, the mean PSA value with SD is 55.72±33.40 ng/ml. Similarly, Median PSA value with interquartile range is 54.30 ng/ml.
 Conclusion: PSA level in the blood of men over 40years is highly correlated with a Age, irrespective of diagnosis. In above 40 age group, with advancing age, Carcinoma Prostate becomes more and more common diagnosis than BPH. Similarly, average PSA level is higher in Carcinoma Prostate than BPH.

Histopathological Findings in Prostatic Chips and its Correlation with Prostate Specific Antigen Levels

“…In our study, most of cases were of old age. Similar findings were reported from different studies done by Shah from Pakistan, Rajani from India, Hussain from Iraq and Yadav M from India (1,(11)(12)(13). Literature suggests that the incidence of prostate lesions , commonly BPH and prostate carcinoma ,increase with increasing age (1).…”

“…Rajani D from India reported similar findings in 2020 (1). Similar pattern of lesions was reported by different studies done by Shah, Hussain AG from Iraq, Josephine A, Neha A, Bhatta S, Yadav M (11)(12)(13)(14)(15)(16). Testosterone hormone causes the hypertrophy of the gland by binding to DHT receptors in prostate (2).…”

“…Although literature suggests that serum PSA levels are raised in prostate carcinoma, yet , it is reported to have low specificity and sensitivity (2,11). Therefore, the current study was done in order to find common disease entities in prostate biopsy specimens and correlate these with serum PSA levels.…”

“…The function of PSA is to keep the semen in liquid state (8)(9)(10). The levels of PSA are measured to determine the presence or absence of disease in prostate because the levels are effected if the gland is affected by any disease (11). Recently, the measurement of PSA has become popular as a screening test for ruling out or confirming prostate carcinoma as its levels are raised in prostate carcinoma (1,2).…”

Exploration of Serum Prostatic Specific Antigen Level in Enlarged Prostate with its Histopathological Correlation

“…[ 7 ] reported similar findings with benign prostatic lesions occurring in the mean age of 57.7 ± 4.86 years. Shah RS and Pandey DR[ 8 ] also gave concordant results with their majority of BPH and Carcinoma Prostate in 61–70 years.…”