Discrepancy between PSA Levels and Gleason Score in Prostate Cancer from Northern Nigeria: A Histopathological Analysis

An extensively utilized tumor marker for prostate cancer is prostate-specific antigen (PSA). It's well known that PSA is a marker specific to the prostate rather than a disease. The study aims to determine the relationship between prostate-specific antigen and various prostatic lesions in some states in North-western Nigeria. This study included 224 samples from the histopathology laboratory of two teaching hospitals in North-western Nigeria. Representative tissue was obtained from the samples, and paraffin-embedded tissue blocks were made, sectioned, and stained with hematoxylin and eosin. The slides underwent light microscopy examination for a final assessment and diagnosis. An Electrochemiluminescence immunoassay was used to measure serum PSA levels. The study analyzed 224 samples, revealing benign prostatic hyperplasia in 54.9% of cases, while prostate adenocarcinoma was the most common malignancy, accounting for 35.7% of cases. Normal PSA levels were found in 17.0% of BPH cases and 11.2% of prostate cancer cases. Benign lesions (54.9% BPH) showed elevated PSA (>20 ng/ml) in 27.7% of cases, while 58.8% of malignancies had PSA >20 ng/ml. The findings show a statistically significant correlation (p <0.05) between prostatic lesions and serum total PSA levels, and no significant association between PSA levels and Gleason scores (r = 0.098, p>0.05). Serum PSA levels can rise due to both benign and malignant tumors, and the likelihood that a benign disease would progress to a malignant one increases with increased PSA levels. Adults over 40 must consider preventative steps like prostate cancer screening.