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Urogenital Pathology
Author(s) -
B Furusato,
Z Chang,
JH Barton,
A Dobi,
S Srivastava,
DG McLeod,
I Rosner,
S Brassell,
MM Shevchuk,
BD Robinson,
A Aggarwal,
J Sterling,
J Dubin,
DS Scherr,
S Mukherjee
Publication year - 2012
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/j.1365-2559.2012.04359_26.x
Subject(s) - citation , genitourinary system , library science , medicine , pathology , computer science , anatomy
In the past prostate cancer was thought to have a low incidence in Africa, but empirical clinical/pathological observations in Ghana and West Africa suggest that the disease may be more common than originally believed. This study determined the clinico-pathologic features of prostate cancer in patients attending the urology clinic at Korle-bu Teaching Hospital, Accra, Ghana. Patients and Methods: One hundred and fifty male patients 45 years and older with abnormal DRE/raised or rising PSA had TRUS biopsy done. The biopsies were processed routinely and all cancer positive slides were graded using the Gleason scoring system. DRE was comparatively analysed statistically against PSA and histological findings. Results: Of the 150 subjects, 79 had cancer (52.7%). Abnormalities on DRE found to be highly significant were irregularity (v = 9.397, df = 1, P = 0.002), induration (v = 21.579, df = 1, P = 0.001) and hardness (v = 49.578, df = 1, P = 0.001). Serum total PSA ranged between 8.3 and 6305 ng/mL with a mean of 247.7 ng/mL and was >10 ng/mL for all but two of the subjects with cancer. PSA density was raised (>0.15) in majority of the subjects, ranging between 0.5 and 110.2. Majority of the tumours were medium to high grade; the mean combined Gleason score was 7.61 (SD – 1.23). Conclusion: The data shows that most of the patients in our setting present late with advanced disease. Total PSA above 10 ng/mL remains a strong indication for prostate biopsy in Ghanaian men. Together with DRE, it can be used to improve prostate cancer detection in Ghanaian men over 45 years.