Study on correlation of serum Prostate specific antigen (psa) levels In various lesions of prostate.

Abstract

INTRODUCTION: Incidence of prostatic diseases, Benign prostatic hyperplasia (BPH) and carcinoma prostate increases with age. BPH, prostate carcinoma and prostatitis are three pathologic processes which frequently affect the prostate gland. Prostate specific antigen (PSA) is a neutral serine protease secreted exclusively by prostatic epithelial cells. OBJECTIVES: As the levels of PSA are increased in neoplastic, non-neoplastic and inflammatory conditions of prostate with overlapping values at times, this study was undertaken to correlate the levels of serum PSA in various lesions of prostate. MATERIALS AND METHODS: Transurethral resection of prostate (TURP) and biopsy specimens were taken in the study. Tissue was submitted till 4 cassettes were filled, and one additional cassette for each 10 gram of tissue was submitted. When specimen was large, the TURP chips showing soft or rubbery, and yellow grey in colour were chosen for processing. The sections were cut at 3-5 micron thickness and subsequently were stained by haematoxylin and eosin stain. In case of biopsy specimens, all cores were embedded followed by sectioning and staining similar to TURP specimens was done. RESULT: Out of total 60 prostatic specimens studied 42 cases were benign. Among benign lesions BPH was the commonest followed by BPH associated with prostatitis, PIN, infarct with squamous metaplasia, cystitis cystica and abscess. 16 cases were of adenocarcinoma of prostate. Majority of adenocarcinoma (8) were in Group 1 with Gleason score ≤ 6 followed by Group 5 adenocarcinoma (4) having Gleason score 9 XI 10. In majority of benign cases serum PSA levels were in the range of 4-10 ng/mL while majority of adenocarcinoma cases showed PSA >20 ng/mL. CONCLUSION: BPH was the commonest lesion followed by adenocarcinoma. Serum PSA levels in the range of 4-10 ng/mL, and values more than 20 ng/mL were significantly associated with benign and malignant lesions respectively in majority of the cases. However PSA is not cancer specific rather prostate specific and elevated serum PSA >20 ng/mL levels do not always result from prostate cancer. BPH along with prostatitis and other associated benign lesions may also cause significant elevations in serum PSA levels.