title: Predicting Gleason score using the initial serum total prostate-specific antigen in Black men with symptomatic prostate adenocarcinoma in Nigeria.
abstract: BACKGROUND
  Men of Black African descent are known to have the highest incidence of prostate cancer. The disease is also more aggressive in this group possibly due to biologically more aggressive tumor or late presentation. Currently, serum prostate-specific antigen (PSA) assay plays a significant role in making the diagnosis of prostate cancer. However, the obtained value of serum PSA may not directly relate with the Gleason score (GS), a measure of tumor aggression in prostate cancer. This study explores the relationship between serum total PSA at presentation (iPSA) and GS.
  
  
  METHODS
  The iPSA of patients with histologically confirmed prostate cancer was compared with the obtained GS of the prostate biopsy specimens. The age of the patients at presentation and the prostate volumes were also analyzed with respect to the iPSA and GS. The data were analyzed retrospectively using IBM SPSS Version 20. Pearson correlation was used for numeric variables, whereas Fisher's exact test was used for categorical variables. Significance was set at P≤0.05.
  
  
  RESULTS
  There were 205 patients from January 2010 to November 2013 who satisfied the inclusion criteria. iPSA as well as age at presentation and prostate volume were not found to significantly correlate with the primary Gleason grade, the secondary Gleason grade, or the GS. However, the presence of distant metastasis was identified to significantly correlate positively with GS.
  
  
  CONCLUSIONS
  GS may not be confidently predicted by the iPSA. Higher iPSA does not correlate with higher GS and vice versa.
authors.affiliation: Urology Unit, Department of Surgery, College of Medicine, Enugu Campus, University of Nigeria, Enugu, Nigeria.
authors.forename: Ikenna I
authors.initials: II
authors.lastname: Nnabugwu
authors.affiliation: Urology Unit, Department of Surgery, College of Medicine, Enugu Campus, University of Nigeria, Enugu, Nigeria.
authors.forename: Emeka I
authors.initials: EI
authors.lastname: Udeh
authors.affiliation: Urology Unit, Department of Surgery, College of Medicine, Enugu Campus, University of Nigeria, Enugu, Nigeria.
authors.forename: Fredrick O
authors.initials: FO
authors.lastname: Ugwumba
authors.affiliation: Urology Unit, Department of Surgery, College of Medicine, Enugu Campus, University of Nigeria, Enugu, Nigeria.
authors.forename: Francis O
authors.initials: FO
authors.lastname: Ozoemena
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000473:pathology*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D044383:Black People; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009549:Nigeria; D009929:Organ Size; D011467:Prostate / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D012189:Retrospective Studies; D014463:Ultrasonography
chemical_list: D017430:Prostate-Specific Antigen
keywords: Gleason score; PSA; patient age; prostate adenocarcinoma; prostate volume