Serum total prostate-specific antigen values in men with symptomatic prostate enlargement in Nigeria: role in clinical decision-making

Figures & data

Table 1 Age distribution of patients

Age (years)	Frequency (%)	Mean tPSA (ng/mL)	n
40–49	1 (7)	0.50±0.00	1
50–59	12 (9.0)	7.76±7.37	11
60–69	54 (40.3)	18.95±24.35	47
70–79	43 (32.1)	30.71±33.65	39
80–89	22 (16.4)	31.87±29.90	17
90–99	2 (1.5)	66.70±47.09	2
Total	134 (100.0)	24.35±29.13	117 (r=0.318, P<0.001)

Abbreviation: tPSA, total prostate-specific antigen.

Figure 1 Findings on DRE.

Abbreviation: DRE, digital rectal examination.

Table 2 Serum total prostate-specific antigen

Serum tPSA (ng/mL)	Frequency (%)
>4	87 (74.4)
≤4	30 (25.6)
Total	117 (100.0)

Abbreviation: tPSA, total prostate-specific antigen.

Figure 2 Abdominopelvic ultrasound scan findings.

Table 3 Histology on transrectal core needle prostate biopsy

Histology	Frequency (%)
Adenocarcinoma	26 (56.5)
Benign	19 (41.3)
High-grade PIN	1 (2.2)
Total	46 (100.0)

Abbreviation: PIN, prostatic intraepithelial neoplasia.

Table 4 Histology of prostatectomy specimens

Histology result	Frequency (%)
BPH	18 (78.3)
BPH + prostatitis	4 (17.4)
Adenocarcinoma	1 (4.3)
Total	23 (100.0)

Abbreviation: BPH, benign prostatic hyperplasia.

Table 5 Relationship between age, DRE, serum tPSA, USS, and histology

	Histology		χ^2Yates	P-value
	Benign (n=34)	Malignant (n=28)
aAge ≥65 years	24 (70.6%)	27 (96.4%)	5.366	0.021*
aSuspicious DRE findings	4 (11.8%)	24 (85.7%)	5.319	0.000*
bSerum tPSA (>4 ng/mL)	27 (81.8%)	26 (96.3%)	1.779	0.182
bSerum tPSA (>10 ng/mL)	22 (66.7%)	25 (92.6%)	4.453	0.035*
cSuspicious USS findings	10 (30.3%)	18 (69.2%)	7.345	0.007*

Notes:

* P<0.05 is significant.

a n=62 (34 benign cases, 28 malignant cases)

b n=60 (33 benign cases, 27 malignant cases)

c n=59 (33 benign cases, 26 malignant cases).

Abbreviations: DRE, digital rectal examination; USS, abdominopelvic ultrasonography; tPSA, total prostate-specific antigen.

Figure 3 Summary of histology.

Abbreviations: BPH, benign prostatic hyperplasia; PIN, prostatic intraepithelial neoplasia.

Table 6 Features of prostates with tPSA >4 ng/mL to 10 ng/mL

Histology	DRE	USS	tPSA	Follow-up (months)
BPH	Benign	Suspicious	4.5	16
BPH	Benign	Benign	4.8	30
Adenocarcinoma	Benign	Suspicious	5.2	12
BPH	Benign	Suspicious	6.4	12
Adenocarcinoma	Suspicious	Benign	7	4
BPH	Benign	Benign	7	34
BPH	Benign	Benign	7	36
Adenocarcinoma	Suspicious	Suspicious	8.3	4

Abbreviations: BPH, benign prostatic hyperplasia; DRE, digital rectal examination; USS, abdominopelvic ultrasonography; tPSA, total prostate-specific antigen.

Table 7 Sensitivity parameters

Test	n	TP	TN	FP	FN	Sensitivity	Specificity	PPV	NPV
DRE	62	24	30	4	4	85.7%	88.2%	85.7%	88.2%
PSA >4	60	26	6	27	1	96.3%	18.2%	49.1%	85.7%
PSA >10	60	23	11	22	4	85.2%	33.3%	51.1%	73.3%
USS	60	19	23	10	8	70.4%	69.7%	65.5%	74.2%

Abbreviations: TP, true positive; TN, true negative; FP, false positive; FN, false negative; PPV, positive predictive value; NPV, negative predictive value; DRE, digital rectal examination; PSA, prostate-specific antigen; USS, abdominopelvic ultrasonography.