Nnabugwu Ikenna I, Ugwumba Fred O, Enivwenae Oghenekaro A, Udeh Emeka I, Otene Chris O, Nnabugwu Chinwe A
Urology Unit, Department of Surgery, College of Medicine, University of Nigeria, Nsukka, Nigeria ; Urology Unit, Department of Surgery, Federal Medical Centre, Asaba, Nigeria.
Urology Unit, Department of Surgery, College of Medicine, University of Nigeria, Nsukka, Nigeria.
Clin Interv Aging. 2014 Dec 30;10:89-93. doi: 10.2147/CIA.S73814. eCollection 2015.
Prostatic enlargement is a common cause of bladder outlet obstruction in men in Nigeria. Malignant enlargements must be differentiated from benign enlargements for adequate treatment of each patient. High serum total prostate-specific antigen (tPSA) levels suggest malignancy, but some of the biopsies done due to a serum tPSA value >4 ng/mL would be negative for malignancy because of the low specificity of tPSA for prostate cancer. This study aims to compare the histologic findings of all prostate specimens obtained from core needle biopsy, open simple prostatectomy, and transurethral resection of the prostate with the respective serum tPSA values in an attempt to decipher the role of serum tPSA in the management of these patients.
The case notes of patients attended to from April 2009 to March 2012 were analyzed. Essentially, the age of the patient, findings on digital rectal examination, abdominopelvic ultrasonography report on the prostate, serum tPSA, and histology reports from biopsy or prostatectomy specimens as indicated were extracted for analysis.
The relationship between age, findings on digital rectal examination, serum tPSA, abdominopelvic ultrasonography report, and histology are compared. A statistically significant relationship existed between a malignant histology and age 65 years and older, suspicious findings on digital rectal examination, suspicious ultrasonography findings, and serum tPSA >10 ng/mL, but not tPSA >4 ng/mL.
In Nigerian patients with symptomatic prostate enlargement, serum tPSA should be seen as a continuum with increasing risk of prostate malignancy.
前列腺肿大是尼日利亚男性膀胱出口梗阻的常见原因。为了对每位患者进行充分治疗，必须将恶性肿大与良性肿大区分开来。血清总前列腺特异性抗原（tPSA）水平升高提示恶性肿瘤，但由于tPSA对前列腺癌的特异性较低，一些因血清tPSA值>4 ng/mL而进行的活检结果可能为恶性阴性。本研究旨在比较经芯针活检、开放性单纯前列腺切除术和经尿道前列腺电切术获取的所有前列腺标本的组织学结果与各自的血清tPSA值，以试图解读血清tPSA在这些患者管理中的作用。
分析了2009年4月至2012年3月期间诊治的患者病历。从病历中提取了患者年龄、直肠指检结果、前列腺的腹部盆腔超声检查报告、血清tPSA以及活检或前列腺切除标本的组织学报告等信息进行分析。
比较了年龄、直肠指检结果、血清tPSA、腹部盆腔超声检查报告和组织学之间的关系。恶性组织学与65岁及以上年龄、直肠指检可疑结果、超声检查可疑结果以及血清tPSA>10 ng/mL之间存在统计学显著关系，但与tPSA>4 ng/mL无关。
在有症状的前列腺肿大的尼日利亚患者中，血清tPSA应被视为前列腺恶性肿瘤风险增加的一个连续指标。
