Prostate-specific antigen, digital rectal examination, and prostate cancer detection: A study based on more than 7000 transrectal ultrasound-guided prostate biopsies in Ghana

IF 5 2区医学 Q2 Medicine

Translational Oncology Pub Date : 2024-11-02 DOI:10.1016/j.tranon.2024.102163

James Edward Mensah , Evans Akpakli , Mathew Kyei , Kenneth Klufio , Isaac Asiedu , Kweku Asante , Bernard Toboh , Micheal Darko Ashaley , Ben Molai Addo , Bernard Morton , Erica Akoto Quist

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Abstract

Purpose of the study

This study aims to determine the role of serum prostate-specific antigen (PSA) levels and digital rectal examination (DRE) in predicting the histological outcomes of prostate biopsies by analyzing a database of over 7000 patients who underwent transrectal ultrasound (TRUS)-guided prostate biopsies.

Methods

We conducted a retrospective analysis of men who underwent TRUS-guided prostate biopsies at Korle Bu Teaching Hospital, a tertiary referral center in Accra, Ghana, from July 2005 to December 2022. The biopsies, which included 10 to 12 core samples, were prompted by PSA levels greater than 4.0 ng/mL, abnormal DRE findings, or both. We then correlated histopathology results with PSA and DRE findings.

Results

Out of 7,338 patients who presented for biopsy, 76.3% were between the ages of 60 and 79. Histology reports were available for 5,289 patients, of whom 2,564 (48.5%) were diagnosed with prostate cancer. Cancer detection rates based on PSA levels were as follows: 21.6% for PSA <4 ng/mL, 21.7% for PSA 4-10 ng/mL, 32.7% for PSA 10-20 ng/mL, 53.0% for PSA 20-50 ng/mL, 71.5% for PSA 50-100 ng/mL, and 92.0% for PSA >100 ng/mL. When DRE findings were classified according to the 2016 TNM System (AJCC 8th Edition) as T1, T2, T3, and T4, cancer detection rates were 26.8%, 51.8%, 87.6%, and 95.7%, respectively. The overall cancer detection rate was significantly higher with abnormal DRE findings (64.6% vs. 26.7%, p < 0.001). Additionally, 78.2% of the detected cancers were high-grade (Gleason score of 7 or more).

Conclusion

This extensive study of Ghanaian men undergoing TRUS biopsies reveals a high prostate cancer detection rate, with nearly 80% of the detected cancers being high-grade. These findings underscore the importance of PSA and DRE in the early detection of prostate cancer and should be considered in patient counseling and discussions regarding the implementation of prostate cancer screening programs in this population.

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前列腺特异性抗原、数字直肠检查和前列腺癌检测：基于加纳 7000 多例经直肠超声引导前列腺活检的研究。

研究目的本研究旨在通过分析7000多名接受经直肠超声（TRUS）引导的前列腺活检患者的数据库，确定血清前列腺特异性抗原（PSA）水平和数字直肠检查（DRE）在预测前列腺活检组织学结果方面的作用：我们对2005年7月至2022年12月期间在加纳阿克拉三级转诊中心Korle Bu教学医院接受TRUS引导下前列腺活检的男性患者进行了回顾性分析。活组织检查包括 10 到 12 个核心样本，其原因是 PSA 水平超过 4.0 纳克/毫升、DRE 结果异常或两者兼而有之。然后，我们将组织病理学结果与 PSA 和 DRE 结果进行了关联：在接受活组织检查的 7,338 名患者中，76.3% 的患者年龄在 60 至 79 岁之间。5,289 名患者获得了组织学报告，其中 2,564 人（48.5%）被确诊为前列腺癌。根据 PSA 水平得出的癌症检出率如下：PSA 100 纳克/毫升的癌症检出率为 21.6%。如果根据 2016 TNM 系统（AJCC 第 8 版）将 DRE 结果分为 T1、T2、T3 和 T4，癌症检出率分别为 26.8%、51.8%、87.6% 和 95.7%。DRE 结果异常的癌症总检出率明显更高（64.6% 对 26.7%，P < 0.001）。此外，78.2%的癌症为高级别癌症（Gleason评分为7分或以上）：这项针对接受 TRUS 活检的加纳男性的广泛研究显示，前列腺癌的检出率很高，其中近 80% 的癌症为高级别。这些发现强调了前列腺特异性抗原（PSA）和前列腺特异性抗原（DRE）在早期发现前列腺癌方面的重要性，在对患者进行咨询和讨论如何在这些人群中实施前列腺癌筛查计划时应考虑到这一点。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Translational Oncology ONCOLOGY-

CiteScore

8.40

自引率

2.00%

发文量

314

审稿时长

54 days

期刊介绍： Translational Oncology publishes the results of novel research investigations which bridge the laboratory and clinical settings including risk assessment, cellular and molecular characterization, prevention, detection, diagnosis and treatment of human cancers with the overall goal of improving the clinical care of oncology patients. Translational Oncology will publish laboratory studies of novel therapeutic interventions as well as clinical trials which evaluate new treatment paradigms for cancer. Peer reviewed manuscript types include Original Reports, Reviews and Editorials.