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Abstract
Introduction. Prostate cancer is the most common cancer in men over 60 worldwide and as well as in Gabon. Its diagnosis is made histologically, nevertheless, can be suggested by a serum total prostate-specific antigen value greater than 4 ng/mL. However, this value can be elevated in the presence of any prostate pathology. The objective of this study was to assess the risk of a diagnosis of high-grade prostate cancer with elevated prostate-specific antigen. Methods. This was a case-control study that took place in January 2022 in the Pathology Anatomy Department's lab of the Faculty of Medicine of Libreville. Serum total prostate-specific antigen levels were compared to histological analyzes of biopsies from 2018-2020. Results. 232 biopsies were studied including 134 prostate cancers and 89 benign prostatic hypertrophies. There was an increasingly positive correlation between the level of prostate-specific antigen and the histological diagnosis of cancer. The risk of high-grade cancer was 37 times greater with a total prostate-specific antigen level above 100 ng/mL. Conclusion. The relationship between the level of total prostate-specific antigen and the risk of high-grade prostate cancer is clearly visible in this study. Nonetheless, there is a high number of patients with an elevated serum total prostate-specific antigen value associated with an absence of histological lesions of cancer.
RÉSUMÉ
Introduction. Le cancer de la prostate est le cancer le plus fréquent chez les hommes de plus de 60 ans dans le monde et au Gabon. Son diagnostic est histologique mais peut être évoqué devant une valeur d’antigène spécifique de la prostate total sérique supérieur à 4 ng/mL. Cependant, cette valeur peut être dépassée devant toute pathologie de la prostate. L’objectif de cette étude était d’évaluer le risque d’un diagnostic de cancer de la prostate de haut grade avec un antigène spécifique de la prostate élevé. Méthodologie. Il s’agissait d’une étude cas-témoins qui s’est déroulé de janvier 2022 dans le Service d’Anatomie pathologie de la Faculté de médecine de Libreville. Les tests d’antigènes spécifiques de la prostate total sérique ont été comparés aux analyses histologiques des biopsies de 2018-2020. Résultats. 232 biopsies ont été étudiées dont 134 cancers de la prostate et 89 hypertrophies bénignes de la prostate. Il existait une corrélation positive croissante entre le niveau d’antigène spécifique de la prostate et le diagnostic histologique de cancer. Le risque de cancer de haut grade était 37 fois plus important avec un niveau d’antigène spécifique de la prostate total supérieur à 100 ng/mL. Conclusion. La relation entre le niveau d’antigène spécifique de la prostate total et le risque de cancer de la prostate de haut grade est bien visible dans cette étude. Toutefois, il existe un nombre élevé de patients avec une valeur d’antigène spécifique de la prostate total sérique élevée associé à une absence de lésion histologique de cancer.
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References
- Catalona WJ, Smith DS, Ratliff TL, Dodds KM, Coplen DE, Yuan JJJ, et al. Measurement of Prostate-Specific Antigen in Serum as a Screening Test for Prostate Cancer. N Engl J Med. 25 avr 1991;324(17):1156‑61.
- Brawer MK, Chetner MP, Beatie J, Buchner DM, Vessella RL, Lange PH. Screening for Prostatic Carcinoma with Prostate Specific Antigen. Journal of Urology. mars 1992;147(3 Part 2):841‑5.
- Cooner WH, Mosley BR, Rutherford CL, Beard JH, Pond HS, Terry WJ, et al. Prostate Cancer Detection in a Clinical Urological Practice by Ultrasonography, Digital Rectal Examination and Prostate Specific Antigen. Journal of Urology. juin 1990;143(6):1146‑52.
- Ondziel Opara A, Banga Mouss R, Ondongo Atipo A, Dimi Nyanga Y, Odzébé A, Bouya P. Le Cancer de la Prostate chez les Sujets de Plus de 75 ans à Brazzaville. Health Sci Dis. janv 2021;22(1):33‑6.
- Mottet N, Bellmunt J, Bolla M, Briers E, Cumberbatch MG, De Santis M, et al. EAU-ESTRO-SIOG Guidelines on Prostate Cancer. Part 1: Screening, Diagnosis, and Local Treatment with Curative Intent. European Urology. avr 2017;71(4):618‑29.
- Moyer VA, U.S. Preventive Services Task Force. Screening for prostate cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 17 juill 2012;157(2):120‑34.
- Pinsky PF, Miller E, Prorok P, Grubb R, Crawford ED, Andriole G. Extended follow-up for prostate cancer incidence and mortality among participants in the Prostate, Lung, Colorectal and Ovarian randomized cancer screening trial. BJU Int. mai 2019;123(5):854‑60.
- Hugosson J, Roobol MJ, Månsson M, Tammela TLJ, Zappa M, Nelen V, et al. A 16-yr Follow-up of the European Randomized study of Screening for Prostate Cancer. European Urology. juill 2019;76(1):43‑51.
- Epstein JI, Egevad L, Amin MB, Delahunt B, Srigley JR, Humphrey PA. The 2014 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason Grading of Prostatic Carcinoma: Definition of Grading Patterns and Proposal for a New Grading System. American Journal of Surgical Pathology. févr 2016;40(2):244‑52.
- D’Amico AV. Biochemical Outcome After Radical Prostatectomy, External Beam Radiation Therapy, or Interstitial Radiation Therapy for Clinically Localized Prostate Cancer. JAMA. 16 sept 1998;280(11):969.
- Mohler JL, Armstrong AJ, Bahnson RR, D’Amico AV, Davis BJ, Eastham JA, et al. Prostate Cancer, Version 1.2016. J Natl Compr Canc Netw. janv 2016;14(1):19‑30.
- Hilscher M, Røder A, Helgstrand JT, Klemann N, Brasso K, Vickers AJ, et al. Risk of prostate cancer and death after benign transurethral resection of the prostate—A 20‐year population‐based analysis. Cancer. 15 oct 2022;128(20):3674‑80.
- Plym A, Zhang Y, Stopsack KH, Jee YH, Wiklund F, Kibel AS, et al. Family History of Prostate and Breast Cancer Integrated with a Polygenic Risk Score Identifies Men at Highest Risk of Dying from Prostate Cancer before Age 75 Years. Clinical Cancer Research. 14 nov 2022;28(22):4926‑33.
- Lin DW, Crawford ED, Keane T, Evans B, Reid J, Rajamani S, et al. Identification of men with low-risk biopsy-confirmed prostate cancer as candidates for active surveillance. Urologic Oncology: Seminars and Original Investigations. juin 2018;36(6):310.e7-310.e13.
- Rouvière O, Puech P, Renard-Penna R, Claudon M, Roy C, Mège-Lechevallier F, et al. Use of prostate systematic and targeted biopsy on the basis of multiparametric MRI in biopsy-naive patients (MRI-FIRST): a prospective, multicentre, paired diagnostic study. The Lancet Oncology. janv 2019;20(1):100‑9.
- Bennett A, Beck A, Shaver N, Grad R, LeBlanc A, Limburg H, et al. Screening for prostate cancer: protocol for updating multiple systematic reviews to inform a Canadian Task Force on Preventive Health Care guideline update. Syst Rev. 26 oct 2022;11(1):230.
- Epstein JI, Egevad L, Amin MB, Delahunt B, Srigley JR, Humphrey PA. The 2014 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason Grading of Prostatic Carcinoma: Definition of Grading Patterns and Proposal for a New Grading System. American Journal of Surgical Pathology. févr 2016;40(2):244‑52.
- Lowrance,* WT, Breau RH, Chou R, Chapin BF, Crispino T, Dreicer R, et al. Advanced Prostate Cancer: AUA/ASTRO/SUO Guideline PART II. Journal of Urology. janv 2021;205(1):22‑9.
- Duffy MJ. Prostate-specific antigen: does the current evidence support its use in prostate cancer screening? Ann Clin Biochem. juill 2011;48(4):310‑6.
- Akinremi TO, Ogo CN, Olutunde AO. Review of prostate cancer research in Nigeria. Infect Agents Cancer. déc 2011;6(S2):S8.
- Niang L, Kouka CN, Jalloh M, Gueye SM. Screening for Prostate Cancer by Digital Rectal Examination and PSA Determination in Senegal. ISRN Oncology. 10 juill 2011;2011:1‑4.
- Freedman ML, Haiman CA, Patterson N, McDonald GJ, Tandon A, Waliszewska A, et al. Admixture mapping identifies 8q24 as a prostate cancer risk locus in African-American men. Proc Natl Acad Sci USA. 19 sept 2006;103(38):14068‑73.
- Mavropoulos JC, Partin AW, Amling CL, Terris MK, Kane CJ, Aronson WJ, et al. Do Racial Differences in Prostate Size Explain Higher Serum Prostate-Specific Antigen Concentrations Among Black Men? Urology. juin 2007;69(6):1138‑42.
- Haiman CA, Chen GK, Blot WJ, Strom SS, Berndt SI, Kittles RA, et al. Characterizing Genetic Risk at Known Prostate Cancer Susceptibility Loci in African Americans. Dermitzakis ET, éditeur. PLoS Genet. 26 mai 2011;7(5):e1001387.
- Ilic D, Djulbegovic M, Jung JH, Hwang EC, Zhou Q, Cleves A, et al. Prostate cancer screening with prostate-specific antigen (PSA) test: a systematic review and meta-analysis. BMJ. 5 sept 2018;k3519.
- Gilbert R, Martin RM, Evans DM, Tilling K, Davey Smith G, Kemp JP, et al. Incorporating Known Genetic Variants Does Not Improve the Accuracy of PSA Testing to Identify High Risk Prostate Cancer on Biopsy. Shore N, éditeur. PLoS ONE. 2 oct 2015;10(10):e0136735.
- Gudmundsson J, Besenbacher S, Sulem P, Gudbjartsson DF, Olafsson I, Arinbjarnarson S, et al. Genetic Correction of PSA Values Using Sequence Variants Associated with PSA Levels. Sci Transl Med [Internet]. 15 déc 2010 [cité 16 sept 2022];2(62). Disponible sur: https://www.science.org/doi/10.1126/scitranslmed.3001513
- Hoffmann TJ, Passarelli MN, Graff RE, Emami NC, Sakoda LC, Jorgenson E, et al. Genome-wide association study of prostate-specific antigen levels identifies novel loci independent of prostate cancer. Nat Commun. avr 2017;8(1):14248.
- Benafif S, Kote-Jarai Z, Eeles RA. A Review of Prostate Cancer Genome-Wide Association Studies (GWAS). Cancer Epidemiology, Biomarkers & Prevention. 1 août 2018;27(8):845‑57.
- Gudmundsson J, Sigurdsson JK, Stefansdottir L, Agnarsson BA, Isaksson HJ, Stefansson OA, et al. Genome-wide associations for benign prostatic hyperplasia reveal a genetic correlation with serum levels of PSA. Nat Commun. déc 2018;9(1):4568.
- Li W, Bicak M, Sjoberg DD, Vertosick E, Dahlin A, Melander O, et al. Genome‐wide association study identifies novel single nucleotide polymorphisms having age‐specific effect on prostate‐specific antigen levels. Prostate. déc 2020;80(16):1405‑12.
- Yang M, Xie W, Mostaghel E, Nakabayashi M, Werner L, Sun T, et al. SLCO2B1 and SLCO1B3 May Determine Time to Progression for Patients Receiving Androgen Deprivation Therapy for Prostate Cancer. JCO. 20 juin 2011;29(18):2565‑73.
- Quail DF, Joyce JA. Microenvironmental regulation of tumor progression and metastasis. Nat Med. nov 2013;19(11):1423‑37.
- Tarantino G, Crocetto F, Vito CD, Martino R, Pandolfo SD, Creta M, et al. Clinical factors affecting prostate-specific antigen levels in prostate cancer patients undergoing radical prostatectomy: a retrospective study. Future Science OA. mars 2021;7(3):FSO643.
- Press DJ, Pierce B, Lauderdale DS, Aschebrook-Kilfoy B, Lin Gomez S, Hedeker D, et al. Tobacco and marijuana use and their association with serum prostate-specific antigen levels among African American men in Chicago. Preventive Medicine Reports. déc 2020;20:101174.
- Karunasinghe N, Minas TZ, Bao BY, Lee A, Wang A, Zhu S, et al. Assessment of factors associated with PSA level in prostate cancer cases and controls from three geographical regions. Sci Rep. déc 2022;12(1):55.
- Loeb S, Lilja H, Vickers A. Beyond prostate-specific antigen: utilizing novel strategies to screen men for prostate cancer. Curr Opin Urol. sept 2016;26(5):459‑65.
References
Catalona WJ, Smith DS, Ratliff TL, Dodds KM, Coplen DE, Yuan JJJ, et al. Measurement of Prostate-Specific Antigen in Serum as a Screening Test for Prostate Cancer. N Engl J Med. 25 avr 1991;324(17):1156‑61.
Brawer MK, Chetner MP, Beatie J, Buchner DM, Vessella RL, Lange PH. Screening for Prostatic Carcinoma with Prostate Specific Antigen. Journal of Urology. mars 1992;147(3 Part 2):841‑5.
Cooner WH, Mosley BR, Rutherford CL, Beard JH, Pond HS, Terry WJ, et al. Prostate Cancer Detection in a Clinical Urological Practice by Ultrasonography, Digital Rectal Examination and Prostate Specific Antigen. Journal of Urology. juin 1990;143(6):1146‑52.
Ondziel Opara A, Banga Mouss R, Ondongo Atipo A, Dimi Nyanga Y, Odzébé A, Bouya P. Le Cancer de la Prostate chez les Sujets de Plus de 75 ans à Brazzaville. Health Sci Dis. janv 2021;22(1):33‑6.
Mottet N, Bellmunt J, Bolla M, Briers E, Cumberbatch MG, De Santis M, et al. EAU-ESTRO-SIOG Guidelines on Prostate Cancer. Part 1: Screening, Diagnosis, and Local Treatment with Curative Intent. European Urology. avr 2017;71(4):618‑29.
Moyer VA, U.S. Preventive Services Task Force. Screening for prostate cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 17 juill 2012;157(2):120‑34.
Pinsky PF, Miller E, Prorok P, Grubb R, Crawford ED, Andriole G. Extended follow-up for prostate cancer incidence and mortality among participants in the Prostate, Lung, Colorectal and Ovarian randomized cancer screening trial. BJU Int. mai 2019;123(5):854‑60.
Hugosson J, Roobol MJ, Månsson M, Tammela TLJ, Zappa M, Nelen V, et al. A 16-yr Follow-up of the European Randomized study of Screening for Prostate Cancer. European Urology. juill 2019;76(1):43‑51.
Epstein JI, Egevad L, Amin MB, Delahunt B, Srigley JR, Humphrey PA. The 2014 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason Grading of Prostatic Carcinoma: Definition of Grading Patterns and Proposal for a New Grading System. American Journal of Surgical Pathology. févr 2016;40(2):244‑52.
D’Amico AV. Biochemical Outcome After Radical Prostatectomy, External Beam Radiation Therapy, or Interstitial Radiation Therapy for Clinically Localized Prostate Cancer. JAMA. 16 sept 1998;280(11):969.
Mohler JL, Armstrong AJ, Bahnson RR, D’Amico AV, Davis BJ, Eastham JA, et al. Prostate Cancer, Version 1.2016. J Natl Compr Canc Netw. janv 2016;14(1):19‑30.
Hilscher M, Røder A, Helgstrand JT, Klemann N, Brasso K, Vickers AJ, et al. Risk of prostate cancer and death after benign transurethral resection of the prostate—A 20‐year population‐based analysis. Cancer. 15 oct 2022;128(20):3674‑80.
Plym A, Zhang Y, Stopsack KH, Jee YH, Wiklund F, Kibel AS, et al. Family History of Prostate and Breast Cancer Integrated with a Polygenic Risk Score Identifies Men at Highest Risk of Dying from Prostate Cancer before Age 75 Years. Clinical Cancer Research. 14 nov 2022;28(22):4926‑33.
Lin DW, Crawford ED, Keane T, Evans B, Reid J, Rajamani S, et al. Identification of men with low-risk biopsy-confirmed prostate cancer as candidates for active surveillance. Urologic Oncology: Seminars and Original Investigations. juin 2018;36(6):310.e7-310.e13.
Rouvière O, Puech P, Renard-Penna R, Claudon M, Roy C, Mège-Lechevallier F, et al. Use of prostate systematic and targeted biopsy on the basis of multiparametric MRI in biopsy-naive patients (MRI-FIRST): a prospective, multicentre, paired diagnostic study. The Lancet Oncology. janv 2019;20(1):100‑9.
Bennett A, Beck A, Shaver N, Grad R, LeBlanc A, Limburg H, et al. Screening for prostate cancer: protocol for updating multiple systematic reviews to inform a Canadian Task Force on Preventive Health Care guideline update. Syst Rev. 26 oct 2022;11(1):230.
Epstein JI, Egevad L, Amin MB, Delahunt B, Srigley JR, Humphrey PA. The 2014 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason Grading of Prostatic Carcinoma: Definition of Grading Patterns and Proposal for a New Grading System. American Journal of Surgical Pathology. févr 2016;40(2):244‑52.
Lowrance,* WT, Breau RH, Chou R, Chapin BF, Crispino T, Dreicer R, et al. Advanced Prostate Cancer: AUA/ASTRO/SUO Guideline PART II. Journal of Urology. janv 2021;205(1):22‑9.
Duffy MJ. Prostate-specific antigen: does the current evidence support its use in prostate cancer screening? Ann Clin Biochem. juill 2011;48(4):310‑6.
Akinremi TO, Ogo CN, Olutunde AO. Review of prostate cancer research in Nigeria. Infect Agents Cancer. déc 2011;6(S2):S8.
Niang L, Kouka CN, Jalloh M, Gueye SM. Screening for Prostate Cancer by Digital Rectal Examination and PSA Determination in Senegal. ISRN Oncology. 10 juill 2011;2011:1‑4.
Freedman ML, Haiman CA, Patterson N, McDonald GJ, Tandon A, Waliszewska A, et al. Admixture mapping identifies 8q24 as a prostate cancer risk locus in African-American men. Proc Natl Acad Sci USA. 19 sept 2006;103(38):14068‑73.
Mavropoulos JC, Partin AW, Amling CL, Terris MK, Kane CJ, Aronson WJ, et al. Do Racial Differences in Prostate Size Explain Higher Serum Prostate-Specific Antigen Concentrations Among Black Men? Urology. juin 2007;69(6):1138‑42.
Haiman CA, Chen GK, Blot WJ, Strom SS, Berndt SI, Kittles RA, et al. Characterizing Genetic Risk at Known Prostate Cancer Susceptibility Loci in African Americans. Dermitzakis ET, éditeur. PLoS Genet. 26 mai 2011;7(5):e1001387.
Ilic D, Djulbegovic M, Jung JH, Hwang EC, Zhou Q, Cleves A, et al. Prostate cancer screening with prostate-specific antigen (PSA) test: a systematic review and meta-analysis. BMJ. 5 sept 2018;k3519.
Gilbert R, Martin RM, Evans DM, Tilling K, Davey Smith G, Kemp JP, et al. Incorporating Known Genetic Variants Does Not Improve the Accuracy of PSA Testing to Identify High Risk Prostate Cancer on Biopsy. Shore N, éditeur. PLoS ONE. 2 oct 2015;10(10):e0136735.
Gudmundsson J, Besenbacher S, Sulem P, Gudbjartsson DF, Olafsson I, Arinbjarnarson S, et al. Genetic Correction of PSA Values Using Sequence Variants Associated with PSA Levels. Sci Transl Med [Internet]. 15 déc 2010 [cité 16 sept 2022];2(62). Disponible sur: https://www.science.org/doi/10.1126/scitranslmed.3001513
Hoffmann TJ, Passarelli MN, Graff RE, Emami NC, Sakoda LC, Jorgenson E, et al. Genome-wide association study of prostate-specific antigen levels identifies novel loci independent of prostate cancer. Nat Commun. avr 2017;8(1):14248.
Benafif S, Kote-Jarai Z, Eeles RA. A Review of Prostate Cancer Genome-Wide Association Studies (GWAS). Cancer Epidemiology, Biomarkers & Prevention. 1 août 2018;27(8):845‑57.
Gudmundsson J, Sigurdsson JK, Stefansdottir L, Agnarsson BA, Isaksson HJ, Stefansson OA, et al. Genome-wide associations for benign prostatic hyperplasia reveal a genetic correlation with serum levels of PSA. Nat Commun. déc 2018;9(1):4568.
Li W, Bicak M, Sjoberg DD, Vertosick E, Dahlin A, Melander O, et al. Genome‐wide association study identifies novel single nucleotide polymorphisms having age‐specific effect on prostate‐specific antigen levels. Prostate. déc 2020;80(16):1405‑12.
Yang M, Xie W, Mostaghel E, Nakabayashi M, Werner L, Sun T, et al. SLCO2B1 and SLCO1B3 May Determine Time to Progression for Patients Receiving Androgen Deprivation Therapy for Prostate Cancer. JCO. 20 juin 2011;29(18):2565‑73.
Quail DF, Joyce JA. Microenvironmental regulation of tumor progression and metastasis. Nat Med. nov 2013;19(11):1423‑37.
Tarantino G, Crocetto F, Vito CD, Martino R, Pandolfo SD, Creta M, et al. Clinical factors affecting prostate-specific antigen levels in prostate cancer patients undergoing radical prostatectomy: a retrospective study. Future Science OA. mars 2021;7(3):FSO643.
Press DJ, Pierce B, Lauderdale DS, Aschebrook-Kilfoy B, Lin Gomez S, Hedeker D, et al. Tobacco and marijuana use and their association with serum prostate-specific antigen levels among African American men in Chicago. Preventive Medicine Reports. déc 2020;20:101174.
Karunasinghe N, Minas TZ, Bao BY, Lee A, Wang A, Zhu S, et al. Assessment of factors associated with PSA level in prostate cancer cases and controls from three geographical regions. Sci Rep. déc 2022;12(1):55.
Loeb S, Lilja H, Vickers A. Beyond prostate-specific antigen: utilizing novel strategies to screen men for prostate cancer. Curr Opin Urol. sept 2016;26(5):459‑65.