Maseeh Uz Zaman1, Nosheen Fatima, Zafar Sajjad. 1. Department of Radiology, The Aga Khan University Hospital, Karachi, Islamic Republic of Pakistan. maseeh.uzzaman@aku.edu
Abstract
AIM: To find out diagnostic correlation of prostate specific antigen (PSA) and Gleason' s score (GS) with bone metastasis (BM) in newly diagnosed prostate cancer (PC) patients in Pakistan. MATERIALS AND METHODS: This retrospective study included 204 newly diagnosed PC patients who were referred for BS for staging. RESULTS: The mean age, mean PSA and incidence of BM on BS were 71±09 years, 111.0±58.5 ng/ml and 67/204 (33%), respectively. The mean GS of the studied population was 7±1. According to PSA levels, patients were divided into 5 groups: <10 ng/ml (77/204), >10-≤20 ng/ml (4/204), >20-≤50 ng/ml (22/204), >50-≤100 (25/204) and >100 ng/ml (38/204). The incidence of positive BS (%) for BM and mean GS (score ±SD) for each group were 14%, 7±1; 10%, 6±1; 32%, 7±1; 56%, 8∓1 and 82%, 8±1 respectively (significant p value). PSA and GS were statistically significant predictors of BM on BS and their predictive value was additive (p<0.0001). Age was not a predictive factor (non-significant p value). Sensitivity and specificity of PSA at a cut-off 48 ng/ml were 68.3% and 86.1% respectively, while GS at a cut-off>6 was more sensitive (88.9%) and less specific (56.2%) for diagnosing BM. CONCLUSIONS: (1) There is an overall increased incidence of BM in newly diagnosed patients with PC and even at serum PSA level≤20 ng/ml and GS<8; (2) PSA and GS are independent predictors for BM but age is not; (3) in view of possible aggressive behavior of PC in local population, one must be careful in adopting Western guidelines for using BS in newly diagnosed Asian males with PC having PSA≤20 ng/ml and GS <8.
AIM: To find out diagnostic correlation of prostate specific antigen (PSA) and Gleason' s score (GS) with bone metastasis (BM) in newly diagnosed prostate cancer (PC) patients in Pakistan. MATERIALS AND METHODS: This retrospective study included 204 newly diagnosed PC patients who were referred for BS for staging. RESULTS: The mean age, mean PSA and incidence of BM on BS were 71±09 years, 111.0±58.5 ng/ml and 67/204 (33%), respectively. The mean GS of the studied population was 7±1. According to PSA levels, patients were divided into 5 groups: <10 ng/ml (77/204), >10-≤20 ng/ml (4/204), >20-≤50 ng/ml (22/204), >50-≤100 (25/204) and >100 ng/ml (38/204). The incidence of positive BS (%) for BM and mean GS (score ±SD) for each group were 14%, 7±1; 10%, 6±1; 32%, 7±1; 56%, 8∓1 and 82%, 8±1 respectively (significant p value). PSA and GS were statistically significant predictors of BM on BS and their predictive value was additive (p<0.0001). Age was not a predictive factor (non-significant p value). Sensitivity and specificity of PSA at a cut-off 48 ng/ml were 68.3% and 86.1% respectively, while GS at a cut-off>6 was more sensitive (88.9%) and less specific (56.2%) for diagnosing BM. CONCLUSIONS: (1) There is an overall increased incidence of BM in newly diagnosed patients with PC and even at serum PSA level≤20 ng/ml and GS<8; (2) PSA and GS are independent predictors for BM but age is not; (3) in view of possible aggressive behavior of PC in local population, one must be careful in adopting Western guidelines for using BS in newly diagnosed Asian males with PC having PSA≤20 ng/ml and GS <8.
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