Correlation of serum prostate-specific antigen and histopathology of prostate cancer in Mahasarakham Hospital
Abstract
Abstract
Background: Prostate cancer is the 4th most common cancer in Thailand. At present, prostate cancer is screened using a prostate-specific antigen (PSA) marker, but the usefulness of its use for helping to diagnose prostate cancer in Mahasarakham Hospital has not been assessed.
Objective: To study correlation of serum prostate-specific antigen and histopathology of prostate cancer and evaluating its diagnostic performance in Mahasarakham hospital.
Materials and methods: Research design is analytic study by retrospective data collection. Eighty patients who had performed prostate biopsy or TUR-P since 1 January 2019 to 31 December 2021. Correlation of PSA level and histopathology result was investigated. Diagnostic performance of PSA was evaluated by determining sensitivity, specificity, positive predictive value, negative predictive value, accuracy, likelihood ratio for positive test (LHR+), likelihood ratio for negative test (LHR-) and area under ROC curve.
Result: Patient age ranged from 50 to 79 years (mean 66.8±6.56 years). Mean of PSA was 47.69±48.896 ng/mL (range from 0.31 to 244.00 ng/mL). There were 40 patients diagnosed with adenocarcinoma, 3 patients diagnosed with chronic inflammation, 37 patients diagnosed with nodular hyperplasia. PSA >10 ng/mL and >20 ng/mL were significantly correlated with prostate cancer pathological findings (p-value <0.001). A cut-off value of 20 ng/mL PSA is more appropriate than other cut-off values to diagnose prostate cancer. PSA is also high accurate in diagnosing prostate cancer. (Area under ROC curve is 0.919, 95%CI is 0.856-0.983, p-value < 0.001).
Discussion and conclusion: This study found that at different cut-off values, PSA has different diagnostic performance for prostate cancer. The 20 ng/mL cut-off is the most suitable point for clinical use in assisting the diagnosis of prostate cancer.
Keywords: Prostate cancer, diagnostic performance, Mahasarakham hospital, prostate-specific
antigen, Serum PSA
