title: Serum total prostate-specific antigen values in men with symptomatic prostate enlargement in Nigeria: role in clinical decision-making.
abstract: BACKGROUND
  Prostatic enlargement is a common cause of bladder outlet obstruction in men in Nigeria. Malignant enlargements must be differentiated from benign enlargements for adequate treatment of each patient. High serum total prostate-specific antigen (tPSA) levels suggest malignancy, but some of the biopsies done due to a serum tPSA value >4 ng/mL would be negative for malignancy because of the low specificity of tPSA for prostate cancer. This study aims to compare the histologic findings of all prostate specimens obtained from core needle biopsy, open simple prostatectomy, and transurethral resection of the prostate with the respective serum tPSA values in an attempt to decipher the role of serum tPSA in the management of these patients.
  
  
  METHODS
  The case notes of patients attended to from April 2009 to March 2012 were analyzed. Essentially, the age of the patient, findings on digital rectal examination, abdominopelvic ultrasonography report on the prostate, serum tPSA, and histology reports from biopsy or prostatectomy specimens as indicated were extracted for analysis.
  
  
  RESULTS
  The relationship between age, findings on digital rectal examination, serum tPSA, abdominopelvic ultrasonography report, and histology are compared. A statistically significant relationship existed between a malignant histology and age 65 years and older, suspicious findings on digital rectal examination, suspicious ultrasonography findings, and serum tPSA >10 ng/mL, but not tPSA >4 ng/mL.
  
  
  CONCLUSIONS
  In Nigerian patients with symptomatic prostate enlargement, serum tPSA should be seen as a continuum with increasing risk of prostate malignancy.
authors.affiliation: Urology Unit, Department of Surgery, College of Medicine, University of Nigeria, Nsukka, Nigeria ; Urology Unit, Department of Surgery, Federal Medical Centre, Asaba, Nigeria.
authors.forename: Ikenna I
authors.initials: II
authors.lastname: Nnabugwu
authors.affiliation: Urology Unit, Department of Surgery, College of Medicine, University of Nigeria, Nsukka, Nigeria.
authors.forename: Fred O
authors.initials: FO
authors.lastname: Ugwumba
authors.affiliation: Urology Unit, Department of Surgery, Federal Medical Centre, Asaba, Nigeria.
authors.forename: Oghenekaro A
authors.initials: OA
authors.lastname: Enivwenae
authors.affiliation: Urology Unit, Department of Surgery, College of Medicine, University of Nigeria, Nsukka, Nigeria.
authors.forename: Emeka I
authors.initials: EI
authors.lastname: Udeh
authors.affiliation: Urology Unit, Department of Surgery, Federal Medical Centre, Asaba, Nigeria.
authors.forename: Chris O
authors.initials: CO
authors.lastname: Otene
authors.affiliation: Department of Medical Laboratory Services, Federal Medical Centre, Asaba, Nigeria.
authors.forename: Chinwe A
authors.initials: CA
authors.lastname: Nnabugwu
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D008875:Middle Aged; D009549:Nigeria; D018579:Patient Selection; D011467:Prostate / Q000000981:diagnostic imaging / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy / Q000379:methods*; D011470:Prostatic Hyperplasia / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis / Q000473:pathology; D012189:Retrospective Studies; D014463:Ultrasonography
chemical_list: D017430:Prostate-Specific Antigen
keywords: prostate histology; serum total prostate-specific antigen; symptomatic prostate enlargement