ROLE OF SERUM TOTAL PROSTATE SPECIFIC ANTIGEN (tPSA) AS A TUMOUR MARKER IN PATIENTS WITH PROSTATIC NODULAR LESIONS

Abstract

Background - Prostate cancer is the most common malignancy among ageing males. In India, prostate cancer is identified as the 10th common malignancy. PSA is the preferred serum marker for the early detection and monitoring of patients with prostate cancer. PSA is organ specific and not disease specific hence PSA level is one of the three criteria based on which risk stratification and staging of prostate cancer is   determined. Objectives - 1) To determine the Total Prostate specific antigen level in patients and control. 2) To determine the relationship between tPSA and histopathological findings. 3) To determine the significance of tPSA as a tumor marker.         Materials and Methods - 75 male patients with complaints of prostatic disease and prostatic nodule on per rectal examination and 75 males with no prostatic complaints were included in this study. Adequate blood sample was collected once from patients and control group. Quantitative determination of tPSA was done by ELISA. All patients with prostatic nodule underwent biopsy and were studied by a Pathologist. Data obtained were analysed statistically. Results - The maximum number of patients were in the age group of 60 to 70 years. Among the 75 patients, 24 patients were diagnosed to have BHP, 51 patients had              adenocarcinoma. 12 patients who were diagnosed to have BHP had PSA values greater than 5 ngml. But all the patients who were diagnosed to have adenocarcinoma had their PSA values greater than 5 ngml All the 75 men in the control group had PSA values less than 4 ngml. There was a significant difference in PSA values between prostatic cancer patients, BHP and control group. Conclusion - PSA is a sensitive tumor marker and          reflects the tumor status of the patients. PSA estimation as a single screening tool for the early diagnosis of prostate cancer should not be considered as elevated PSA level is also present in BHP but it is a sensitive and non invasive screening assay, and when supported with histopathology and clinical findings it can become a valuable tool in diagnosis of prostate cancer.