Prostate Specific Antigen Density and Gleason Score-Is there any correlation?

Abstract

Objectives:The primary objective of the study was to correlate the Prostate Specific Antigen Density (PSAD) of prostate cancer according to its Gleason scores, and secondary objective was to correlate the PSAD of benign prostate diseases.

Design: The PSAD values of 128 patients were calculated from our audit data of TRUS & biopsy of the prostate. It was aimed to define the PSAD of benign prostatic diseases like BPH and prostate Inflammation as well as various Gleason grades of prostate adenocarcinoma. The standard cut off value for suspected prostate cancer is PSAD value ≤ 0.15.

Setting:It was a hospital based study. Subjects: The audit study involved all 128 men who had TRUS & biopsy of prostate consecutively from October 2010 to November 2011 by the authors.

Main Outcome Measure: The median and mean values were calculated. Median was chosen as measure of central tendency to prevent influence of extreme outliers in the data and mean was used for measure of significance as well as standard deviation.

Results: The median PSAD values of benign prostate hyperplasia, prostatic inflammation, Gleason 6, Gleason 3+4, Gleason 4+3 and Gleason 8 to 10 were 0.13, 0.28, 0.19, 0.28, 0.35 and 0.62 respectively.

Conclusion: Prostate Specific Antigen Density could predict Gleason grades of prostate cancer and could help in precision of diagnosis, decisions about biopsy & re biopsy as well as prognostication. Prostate Specific Antigen Density complements other diagnostic modalities like multi parametric Magnetic Resonance Imaging (MRI).