1. Comparison of PSA Values of Prostate Cancer Patients Before, During and After Prostate Biopsy
Using Gleason Score
Mehmet KILINC1, Yunus Emre GOGER1, Hasan ESEN2 , Ahmet OZTURK1 , Mehmet BALASAR1
1-Konya Necmettin Erbakan University Meram Medical Faculty Department of Urology TURKEY
2-Konya Necmettin Erbakan University Meram Medical Faculty Department of Pathology TURKEY
Table 1. PSA1, PSA2, PSA3, PSA4, PSA5 Levels According to Groups
Introduction:
The prostate specific antigen (PSA) levels of prostate cancer patients have been measured before, during, and after prostate biopsy. We studied the reaction of cancerous prostate tissue to the changes in PSA levels.
Material and Method:
In the present study 151 patients who underwent prostate biopsy with TRUSG and had prostate cancer according to pathology results were evaluated. The prostate specific antigen levels were measured right after (PSA2, PSA3), 30 minutes (PSA4), and 24 hours (PSA5) following an intervention to the right and left lobes of the prostate. The pathologic specimen obtained during the biopsy was categorized according to Gleason Grading System. Hence four groups were formed. Group 1 consisted of the tissue scored as under 6, group 2 as 6, group 3 as 7, group 4 as above 7 (Table 1). PSA1, PSA2, PSA3, PSA4, and PSA5 levels of the patients were compared according to their groups. Intergroup changes have been measures in pairs using paired difference test. The relation between changes in measured groups and relation between Gleason Score were compared (Table 2).
Results:
PSA1, PSA2, PSA3, PSA4, and PSA5 levels of 151 prostate cancer patients have been measured. Whereas there was not any statistically significant difference among the PSA2-PSA4 pair (p>0.05), there was a significant difference in PSA1-PSA2, PSA1-PSA3, PSA1-PSA4, PSA1-PSA5, PSA2PSA3, PSA2-PSA5, PSA3-PSA4, PSA3-PSA5, PSA4-PSA5 pairs (p<0.05). In the groups categorized according to Gleason Grading System, the higher Gleason score was the less was the statistically meaningful difference among the groups. In both group 1 and 2, there was not any statistically significant difference among the PSA2-PSA4 pair likewise in the PSA3-PSA4 pair in group 3, and PSA2-PSA5 in group 4. The higher the Gleason score was the closer were the increase ratio in PSA2, PSA3, PSA4, and PSA5 levels.
Table 2. Statistical Analysis of PSA Measured Pairs According to Groups
Conclusions:
Despite the increase in PSA levels with the increase in Gleason Score, the difference among the measures PSA pairs decreased. The higher the prostate cancer grade became, the lower did PSA secretion sank. In prostate cancer patients with close scores for measured pairs, Gleason score can also be considered to be high in actual clinical use.