Diagnostic Accuracy of Serum Prostate Specific Antigen (PSA ≥50ng/ml)in Estimating Aggressiveness of Adenocarcinoma of Prostate (GleasonScore ≥7)
Abstract
Objective: To assess the diagnostic accuracy of serum PSA > or = 50ng/ml in estimating aggressiveness of adenocarcinoma of prostate (Gleason score 7 or more). An alternative to the Gleason score (GS), a new grading system for the diagnosis of prostate cancer was applied in this study based on the modified Gleason score grouping which included five Grade groups. The main objective of our study was to evaluate the diagnostic accuracy of PSA level ≥50 ng/ml for evaluation of the aggressiveness of adenocarcinoma prostate (GS ≥7) in patients with this tumor.Methods
This descriptive, cross-sectional study was done at the Histopathology department of Shaikh Zayed Hospital, Lahore, from October 2024 to April 2025. Formalin fixed samples of 338 patients aged 40-70yrs with suspected prostate cancer were done. Pre-biopsy PSA levels were selected through non-probability, consecutive sampling. Eight needle core TRUS biopsies of each patient, received in separate containers fixed in formalin and submitted in separate blocks, were studied after Hematoxylin and Eosin staining. The Gleason score (GS) was calculated. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of PSA ≥50 ng/ml were used to calculate the aggressiveness of adenocarcinoma of prostate (GS ≥7). Demographic information was noted on predesigned proforma.Results
Patients (Mean age=56.43+7.90 years) had a mean duration of 10.36+10.51 months for prostate cancer. Gleason score ≥7 was found in 99 (29.29%) and <7 in 239 (70.71%) patients. Serum PSA levels <50 ng/ml were found in 232 (68.64%) and ≥50 ng/ml in 106 (31.36%). On histopathology, PSA levels ≥50 ng/ml were 65.7% sensitive and 82.8% specific in diagnosing aggressiveness of adenocarcinoma. PSA levels Positive predictive value (PPV) was 61.3% and negative predictive value (NPV) was 85.3%.Conclusion
The serum total PSA was found strongly correlated with tumor diagnosis and tumor aggressiveness. The sensitivity and specificity of serum PSA levels was 65.7% sensitive and 82.8% specific at a cut off value of 50 ng/ml. for diagnosing aggressivenessKeywords:
Prostate Specific antigen, Carcinoma, Gleason's scorePublished
2026/03/04
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