title: Prostate-specific antigen density values among patients with symptomatic prostatic enlargement in Nigeria.
abstract: BACKGROUND
  This study aims to estimate the prostate-specific antigen density (PSAD) cutoff level for detecting prostate cancer (CAP) in Nigerian men with "grey zone PSA" (4-10 ng/ml) and normal digital rectal examination findings. We addressed this research question: Is the international PSAD cutoff of 0.15 ideal for detecting CAP in our symptomatic patients with "grey zone PSA?"
  
  
  METHODS
  
  
  
  OBJECTIVE
  To estimate the prostate-specific antigen density (PSAD) cutoff level for detecting CAP in Nigerian men with "grey zone PSA" (4-10 ng/ml) and normal digital rectal examination findings.
  
  
  METHODS
  Prospective.
  
  
  METHODS
  A tertiary medical center in Enugu, Nigeria.
  
  
  METHODS
  Two hundred and fifty-four men with either benign prostatic hyperplasia (BPH) or CAP were recruited.
  
  
  METHODS
  Patients with PSA above 4 ng/ml or abnormal digital rectal examination or hypoechoic lesion in the prostate were biopsied.
  
  
  METHODS
  PSAD and histology report of BPH or CAP.
  
  
  RESULTS
  Ninety-seven patients had CAP while 157 had benign prostatic hyperplasia (BPH). Seventy-two patients had their serum PSA value within the range of 4.0 and 10 ng/ml. PSAD cutoff level to detect CAP was 0.04 (sensitivity 95.88 %; specificity 28.7 %).
  
  
  CONCLUSIONS
  The PSAD cutoff level generated for Nigerian men in this study is 0.04 which is relatively different from international consensus. This PSAD cutoff level has a positive correlation with histology and could detect patients with CAP who have "grey zone PSA."
authors.affiliation: Department of Surgery, University of Nigeria, Enugu, Nigeria. emeka.udeh@unn.edu.ng.|Department of Surgery, Faculty of medicine, College of medicine, University of Nigeria, Enugu, Nigeria. emeka.udeh@unn.edu.ng.
authors.forename: Emeka I
authors.initials: EI
authors.lastname: Udeh
authors.affiliation: Department of Surgery, University of Nigeria, Enugu, Nigeria.
authors.forename: Ikenna I
authors.initials: II
authors.lastname: Nnabugwu
authors.affiliation: Department of Surgery, University of Nigeria, Enugu, Nigeria.
authors.forename: Francis O
authors.initials: FO
authors.lastname: Ozoemena
authors.affiliation: Department of Surgery, University of Nigeria, Enugu, Nigeria.
authors.forename: Fred O
authors.initials: FO
authors.lastname: Ugwumba
authors.affiliation: Department of Pathology, ESUT University Teaching Hospital, Park Lane, Enugu, Nigeria.
authors.forename: Adesina S O
authors.initials: AS
authors.lastname: Aderibigbe
authors.affiliation: Department of Radiology, University of Nigeria Teaching Hospital, Enugu, Nigeria.
authors.forename: Samuel R
authors.initials: SR
authors.lastname: Ohayi
authors.affiliation: Department of Surgery, University of Nigeria Teaching Hospital, Enugu, Nigeria.
authors.forename: Kevin N
authors.initials: KN
authors.lastname: Echetabu
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D008875:Middle Aged; D009549:Nigeria; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood*; D011470:Prostatic Hyperplasia / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D012680:Sensitivity and Specificity
chemical_list: D017430:Prostate-Specific Antigen
keywords: Nigerian men; Prostate-specific antigen density; Symptomatic prostatic enlargement