prostatic specific antigen(p.s.a)in benign and neoplastic prostate

For the past few years there has been intense interest in carcinoma of the prostate as regards early diagnosis, parameters for staging and prognostic assessment. In our study, we evaluated PSA in benign and malignant prostate, as a diagnostic test for cancer prostate, comparing PSA with other modalities of diagnosis. The study included 43 cases, 37 cases as study patients divided into 3 groups after histopathological examination (BPH, cancer prostate, prostatitis) and 6 cases as a control group. We investigate every case by PSA, DRE and TRUS. According to our results, more than 1/3 of our study cases with BPH (4l. 3 %) have elevated PSA level, also acute prostatitis elevate PSA level. Not only that but 16.7% of our cases with cancer prostate has PSA level within normal range. This means high false negative. PSA sensitivity = 83.3% and PSA specificity 57.8% -Also according to our results DRE sensitivity 66.7% TRUS sensitivity 93.3% specificity = 76.50/0 specificity = 58.8% We conclude that PSA is a prostatic specific not tumour specific, there are many reasons for PSA elevated BPH, prostatitis .... also there is a high false negative result. For all these reasons we can not depend on PSA assay alone as diagnostic test for cancer prostate. Also, we can not depend or DRE alone or TRUS alone, for this we need to combine more than one test to reduce the fallacies in diagnosis according to our results combination of PSA assay with DRE give detection rate nearly equal to 100% and about of 59% of all cases of cancer will diagnosed by this combination. We can reserve TRUS, which is expensive and need expert hand, for cases with positive one test (DRE or PSA) and negative other test.