Correlation between prostate specific antigen, digital rectal examination and histology in patients with prostate cancer

Abstract

Introduction: Prostate cancer remains a health concern worldwide with an increasing global incidence. In Nigerian men it is the most common diagnosed cancer. Diagnosis of prostate cancer is made through biopsy and histology which in turn is dependent on prostate specific antigen and digital rectal examination finding.
Objective: This study sought to look at the correlation between PSA , DRE and histology in patient who had prostate biopsy: (This objective is slightly at variance with what the title of the work says)
Method: It was a prospective study of all patients who presented to our clinic and had prostate biopsy. Data on age of patient, size of prostate, PSA, DRE finding of benign or suspicious for cancer of the prostate and the final histology were collated and there correlation analysed using SPSS and Microsft Excel 2013.
Results: The mean age, prostate volume and PSA were 70.99+ 9.1years, 97.6+ 88.1ml and 70.13 + 73.2ng/ml respectively. The positive predictive value, negative predictive value and overall diagnostic accuracy are 55.61, 66.67, 55.77 respectively for PSA above 4ng/ml , 71.97, 73.68, 72.60 respectively for DRE alone and 55.59, 0.00, 55.29 respectively for a combination of PSA above 4ng/ml and DRE.
Conclusion: PSA and DRE singly or in combination have a poor PPV (including PPV of 55.61 ), NPV and ODA to help counseling of patients prior to prostate biopsy.

Keyword: PSA, DRE, biopsy histology, diagnostic accuracy