EVALUATION OF CHANGES IN THE LEVELS OF PROSTATE SPECIFIC ANTIGEN (PSA) AND PROSTATIC ACID PHOSPHATASE IN PATIENTS PRESENTING WITH URINARY RETENTION AND PROSTATE DISEASE

Abstract

ABSTRACT Prostate specific antigen (PSA) has established itself as the most useful marker for adenocarcinoma of the prostate (ADCA) adenocarcinoma of the prostate and in the recent years has almost replaced the total acid phosphatase and prostatic acid phosphatase prostatic acid phosphatase (PAP) for screening, diagnosis and monitoring the prostate carcinoma patients. The prostate specific antigen levels also rise in benign prostatic hypertrophy benign prostatic hypertrophy but to a lesser extent and high values are usually diagnostic of malignant disease. A cross-sectional comparative study was planned to see the effect of urinary retention and catheterization on plasma concentration of adenocarcinoma of the prostate and prostatic acid phosphatase and the value of this effect in the diagnosis of patients as having benign prostatic hypertrophy or adenocarcinoma of prostate. Sixty patients with prostatic disease were included in the study. Adenocarcinoma of the prostate and prostatic acid phosphatase levels were assessed in all patients. The patients were divided into two groups; group I are those presented with urinary retention and catheterization and group II those presented without urinary retention (without catheter). Following histological examination of prostatic tissues, the patients were diagnosed as cases of benign prostatic hyperplasia or adenocarcinoma of prostate. The data were analyzed using t-test. Benign prostatic hypertrophy was detected in 48 patients whereas 12 patients were diagnosed with adenocarcinoma of the prostate. In the study, 66.2% of benign prostatic hypertrophy and 50% of adenocarcinoma of the prostate patients presented with urinary retention and catheterization. It was observed that prostate specific antigen levels were significantly raised in benign prostatic patients with urinary retention and catheterization as compared to those with no retention. There was, however, no significant rise in prostatic acid phosphatase levels in those patients. In conclusion, prostatic acid phosphatase is still a very good tumor marker of prostatic disease in differentiating the malignant from the benign disease. It appears to be particularly important in patients with benign prostatic hyperplasia and urinary retention as catheterization appears to raise significantly the levels of prostate specific antigen but not those of prostatic acid phosphates. This finding means that patients presenting with urinary retention and catheterization and high prostatic acid phosphates levels are more likely having carcinoma of the prostate because retention and catheterization don’t significantly raise the prostatic acid phosphates levels in benign prostatic hypertrophy as they raise prostate specific antigen levels in such patients.