Correlation of serum PSA level with histomorphologic study in prostatic diseases

Introduction: Worldwide, diseases of prostate gland are responsible for significant morbidity and mortality among adult males. Prostate cancer is the second common cause of cancer related death in men after lung cancer but it can be completely cured if detected in early stage. Aim: To evaluate the histomorphological spectrum of non-neoplastic and neoplastic lesions of prostate and to establish the correlation of histomorphological findings with serum prostate specific antigens levels. Materials and Methods: 1 year Prospective Study was done on 110 patient at Department of Pathology , Indira Gandhi Medical College, Shimla, H.P from 1st July 14 to 30th June 15. Unwilling patient, inadequate biopsies and patient with metastatic carcinoma to prostate were excluded from study. Paraffin embedded sections were stained with routine haematoxylin and eosin stain. The PSA levels were estimated in biochemistry department using automated Chemiluminescence method on Beckman Coulter Access –II System. These values were correlated with histopathological diagnosis. Result: With 63.3%, benign prostatic hyperplasia was the most common lesion followed by Malignancy in 29.1% and prostatic intraepithelial neoplasia in 7.3% of total cases. Serum prostate specific antigens level was increased in 65.5% cases. Mean serum prostate specific antigens value of benign prostatic hyperplasia with and without inflammation is and10.9ng/ml and9.8ng/ml respectively. Mean serum prostate specific antigens value is 18.9 ng/ml in Low Grade and78.5 ng/ml in high grade prostatic intraepithelial neoplasm. Mean serum prostate specific antigen in malignancy was 101.2ng/ml antigen in. Conclusion: On statistical analysis PSA is found to be a sensitive and early marker for the diagnosis of prostate cancer. With a cut off value of 4ng/ml sensitivity was found to be 93.75% and specificity was 46.15%.