Using Prostate-specific Antigen to Predict Gleason Scores in African Men Seeking Urological Services at a Referral Hospital in Kisumu, Kenya

Background: Men are more likely to develop prostate lesions like benign prostatic hypertrophy and prostate cancer as they age. Prostate specific antigen (PSA), which is secreted in large quantities above normal levels of 0–4 ng/ml by cells of the prostate gland in benign prostate hypertrophy (BPH) or prostate cancer (Pca), is a biological marker for the diagnosis of prostate cancer; hence, early diagnosis using PSA facilitates disease detection; the higher the level of PSA, the higher the chance of having prostate cancer (Negahdary et al., 2020; Zhang & Sun, 2018). The Gleason scale is used to grade patients with prostate cancer and determine their risk of the disease progressing. Is it possible to predict the Gleason scores of people with prostate cancer based on their PSA levels? The primary goal of the current study was to establish a correlation between the patient's PSA level and the associated Gleason scores at the time of prostate biopsy at Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH).

Methods: The study utilized a cross-sectional retrospective that focused on patient reports with prostate histology who had a PSA between 2017 and 2022 when they requested a biopsy. The majority of the examined histology reports that did not include a PSA level and thus were disregarded. There were 80 sample reports as a result of this exclusion.

Results: According to the study, 36 (45%) of the patients whose prostate tissues were examined had prostate cancer. The majority of 24 (66.7%) patients who had PSA values more than 50 ng/ml when they were first diagnosed with prostate cancer were classified as Gleason 7/Group 2 or higher. The study sought to determine whether PSA levels and Gleason scores were correlated. Gleason scores and PSA levels have a statistically significant positive correlation (p = 0.004, r = 0.474). The majority of patients, 55 (65%), who had high PSA values (>4 ng/ml), were between the ages of 60 and 79. These patients were followed by those who were >80 years old at 15 (18.75%) and those who were 50 to 59 years old at 10 (10%). Age and PSA levels were shown to have a statistically significant positive Pearson correlation (r = 0.236, p = 0.035, 95% CI).

Conclusions: Gleason scores rise with increasing PSA levels. Age and PSA level have a positive correlation.