Association between prostate-specific antigen density and prostate cancer prediction among Nigerian men

Abudu EK; Okuku CN; Akaiso OE; Fabian UA; Udoh EA; Ukpong AE; Kudamnya IJ; Ajayi OO; Uduma FU; Abudu OO; Ekpo BO

doi:10.61386/imj.v18i1.613

Authors

Abudu EK Department of Histopathology, Faculty of Basic Clinical Medicine, College of Medicine, Chukwuemeka Odumegwu Ojukwu University, Awka Campus, Anambra Ibom State, Nigeria
Okuku CN Department of Chemical Pathology, University of Uyo & Teaching Hospital, Abak Road, Uyo, Akwa Ibom State, Nigeria
Akaiso OE Department of Surgery, University of Uyo & Teaching Hospital, Abak Road, Uyo, Akwa Ibom State, Nigeria
Fabian UA Department of Chemical Pathology, University of Uyo & Teaching Hospital, Abak Road, Uyo, Akwa Ibom State, Nigeria
Udoh EA Department of Surgery, University of Uyo & Teaching Hospital, Abak Road, Uyo, Akwa Ibom State, Nigeria
Ukpong AE Department of Surgery, University of Uyo & Teaching Hospital, Abak Road, Uyo, Akwa Ibom State, Nigeria
Kudamnya IJ Department of Pathology, University of Uyo & Teaching Hospital, Abak Road, Uyo, Akwa Ibom State, Nigeria
Ajayi OO Department of Pathology, University of Uyo & Teaching Hospital, Abak Road, Uyo, Akwa Ibom State, Nigeria
Uduma FU Department of Radiology, University of Uyo & Teaching Hospital, Abak Road, Uyo, Akwa Ibom State, Nigeria
Abudu OO Department of Nursing Services, University of Uyo Teaching Hospital, Abak Road, Uyo, Akwa Ibom State, Nigeria
Ekpo BO Department of Histopathology, Faculty of Basic Clinical Medicine, College of Medicine, Chukwuemeka Odumegwu Ojukwu University, Awka Campus, Anambra Ibom State, Nigeria

DOI:

https://doi.org/10.61386/imj.v18i1.613

Keywords:

Prostate prostate-specific antigen density, predictor, Prostate cancer

Abstract

Background: Prostate - specific antigen density (PSAD) has been shown as a valuable diagnostic and predictive tool for prostate cancer.

Objectives: To ascertain the utility of PSAD in predicting prostate cancer in patients with PSA > 4 .0 ng/ml.

Subjects & Methods: The study was an analytic cross-sectional study comprising 382 patients at the University of Uyo Teaching Hospital with PSA levels of > 4.0 ng/ml and normal or abnormal digital rectal examination findings. PSAD was computed and transrectal ultrasound guided prostate biopsies were performed. Statistical analysis was done using a statistical package for social sciences version 24 (SPSS, IBM, Chicago, IL, United States). Appropriate test statistics including mean, standard deviation, Chi-square, t-test, Fischer’s exact test, Pearson’s r-test) with p-value < 0.05 considered as significant.

Results: The mean age for all the patients was 55.7 + 2.6 year while the mean ages of 52.9 + 3.3 years and 65.1 + 11.3 years were for patients with benign and malignant prostate diseases respectively. 26.2 % were adenocarcinomas. The mean and median of PSAD for prostate cancer were 0.31 + 0.23 and 0.31 ng/mL/cm3 respectively. PSAD had positive predicting association with prostate cancer risk (p=0.004) using univariate logistic regression. The Area Under the Curve (AUC) and optimal cut-off point for the PSAD was 0.9 (95% CI: 0.83–0.97) and 0.052 respectively, indicating strong diagnostic performance for predicting prostate cancer. PSAD showed statistical significance in cancer detection (p < 0.001) with a detection rate, sensitivity and false positive rate of 90.0 %, 85.0 % and 8.0 % respectively.

Conclusion: A PSAD of 0.052 ng/ml/cm³ can be used as a cut-off value to predict prostate cancer when evaluating patients with raised PSA in our population.