International Journal of Medical Science and Public Health | 2017 | Vol 6 | Issue 2 (Online First) 1 Access this article online Website: http://www.ijmsph.com Quick Response Code: DOI: 10.5455/ijmsph.2017.17072016588 Original Research Correlation of serum prostate-specifc antigen level in various prostate pathology in elderly men Varsha S Khant, Hansa Goswami, Pooja Y Shah Department of Pathology, B.J. Medical College, Ahmedabad, Gujarat, India. Correspondence to: Varsha S Khant, E-mail: varshaskhant@gmail.com Received July 17, 2016. Accepted August 4, 2016 Background: Carcinoma of prostate is one of common tumors of old age in men. With digital rectal examination (DRE) prostate-specifc antigen (PSA) is a major screening tool for prostate cancer. While Trans Rectal Ultra Sound (TRUS)- guided needle biopsies of prostate are considered gold standard for the diagnosis of prostate cancers. Objectives: To determine the spectrum of pathological lesions in TRUS-guided needle biopsies of prostate in men with increased serum PSA levels (≥ 4 ng/ml) with or without symptoms of prostatism. Material and Methods: The study was carried out at the Department of Histopathology, B. J. Medical College Civil Hospital, Ahmedabad from January 2015 to October 2015. The study included 110 cases. Serum PSA level and histopathological examination of prostatic biopsies were performed and correlated. Raised serum PSA level were arbitrarily divided into mild (≥ 4–10 ng/ml), moderate (≥ 10.1–20 ng/ml), and marked elevations (≥ 20.1 to highest). Results: The mean age of patients was 66.9 ± 9.4 years. Out of 110 cases, 69 (62.72%) cases were benign and 41 (37.2%) were malignant. Among malignant lesions, all cancers were of moderate to high Gleason grades and scores. Mild serum PSA rise was seen in 63 (57.27%) patients, among these 52 (84.1%) showed benign lesions and 10 (15.9%) malignant. Moderate serum PSA rise was seen in 26 (23.6%) cases, among 12 (46.15%) showed benign and 14 (53.8%) malignant. Briefy, 21 (19.1%) patients had serum PSA level > 20.1 ng/ml. Among these 4 (19.04%) cases were benign and 17 (80.9%) were malignant. Malignant lesions included prostatic adenocarcinoma. Benign lesions included benign prostatic hyperplasia, prostatitis. Conclusion: In the present study, serum PSA level is one of the most useful front line methods for assessing individual’s risk of prostate cancer. In addition, elevated level more than 4.0 ng/ml with TURS-guided needle biopsy is most useful and accurate diagnostic method for prostate. KEY WORDS: Benign prostate hyperplasia, prostatitis, serum prostate-specifc antigen (PSA), adenocarcinoma, Gleason score Abstract International Journal of Medical Science and Public Health Online 2016. © 2016 Varsha S Khant. This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material for any purpose, even commercially, provided the original work is properly cited and states its license. Prostate cancer is the leading cause of new cancer in men and is second only to lung cancer as a leading cause of cancer-related deaths in men. [4] Prostate cancer is the most common cancer of men in USA and 10th common malignancy in India. [1,2] Several factors, including age, race, family history, hormone levels, and environmental infuences are suspected to play a role in pathogenesis. [5] Because of the location of prostate gland at bladder neck, enlargement of the gland leads to problems related to urinary obstruction. [16] The incidence of prostatic diseases, benign prostatic hyperplasia, and carcinoma increases with age. [16] Prostate-specifc antigen (PSA) is the most useful tumor marker in diagnosis and frst line test in screening. [3,4] The increase in serum PSA depends on differentiation of tumor cells. Gleason grading is one of the most powerful predictors Introduction Prostatic carcinoma is an important growing health prob- lem, presenting a challenge to urologists, radiologists and pathologist. [1,2] The incidence of prostatic diseases, benign prostatic hyperplasia, and carcinoma increases with age. [3] 2017. 2017 International Journal of Medical Science and Public Health | 2017 | Vol 6 | Issue 2 257