Correlation between Gleason score of adenocarcinoma prostate and serum PSA levels in the western Himalayan region of India

Abstract

The diseases of the prostate gland are the major cause of morbidity and mortality among adult males worldwide. Prostate cancer is the most common malignant tumour in men over the age of 65 years. The present study was done to evaluate the histomorphological spectrum of malignant lesion of prostate and to establish the correlation between S.PSA (Serum Prostate-Specific Antigen) levels and Gleason’s grade in the Western Himalayan region of India. Histopathological examination of 100 prostatic tissue was done. Serum PSA assessed and its values were correlated with Gleason’s grading of prostate cancer. Malignancy was found in 29 per cent of cases. Conventional adenocarcinoma encountered in 96.6 per cent cases. Undifferentiated carcinoma was reported in 3.4 per cent cases. Serum prostate-specific antigens level was increased in 93.1% of malignant cases. More than 10ng/ml was seen in 68.9 per cent cases. Mean S.PSA level in malignancy was 122.9ng/ml. The Commonest Gleason’s score being seven (37.9 percent).This prospective study concluded that there is a higher percentage of prostatic carcinoma in the Western Himalayan region of India. PSA is found to be a sensitive marker for the diagnosis of prostate cancer. With a cut off value 4ng/ml sensitivity was found to be 93.75% and specificity was 46.15%, and there is a positive correlation between Serum PSA level and Gleason’s grading. Mean serum PSA level of moderately and poorly differentiated carcinoma was 32.15ng/ml and 325.3ng/ml respectively.