Evaluation of Serum Prostatic Acid Phosphatase, Total and Free Prostatic Specific Antigen as Markers of Prostate Cancer in Sudanese Patients

Abstract

In view of the increasing number of patients with prostate problems as the prostate cancer and benign prostatic hyperplasia among the Sudanese population, and due to difficulties in the trans-rectal ultra sound (TRUS) biopsy taken which is unpleasant for the patients. This study was done to achieve the evaluation of Serum Prostatic acid Phosphatase (PAP), Total Prostatic Specific Antigen (TPSA) and Free Prostatic Specific Antigen (FPSA) as markers of prostate cancer in Sudanese patients, in a case control hospital based study in Khartoum state during the period from August 2010 to March 2012, the serum levels of PAP, TPSA and FPSA were measured in 100 patients with Prostatic Carcinoma (PCa), 100 with Benign Prostatic Hyperplasia (BPH) as cases and their mean age was (68±8 years) and hundred apparently healthy volunteer were selected as control un group. A significant raise in TPSA was found in patients with PCa (mean 42.6, P value <0.01) and in patients with BPH (mean 7.8, P value< 0.01) compared to controls. A significant raised in FPSA was found in PCa group (mean 10.27, P value <0.01) and in patients with BPH (mean 2.23, P value< 0.01) compared to controls. The difference in the ratio of F/TPSA is statistically significant in patients with PCa (mean 15.8 P value < 0.01) and statistically insignificant in BPH (mean 30.33 P value > 0.05) compared to controls (mean 30.78). The raise in PAP was statistically insignificant in PCa (mean 37.5, P value > 0.05) while it is statistically significant in patients with BPH (mean 8.81, P value < 0.01) compared to controls (2.18). This study concluded that the Total Prostatic Specific Antigen is more accurate in the screening of prostate cancer when compared with the Prostatic Acid Phosphatase. Calculation of Free/Total Prostatic Specific Antigen ratio improves differentiation of Prostatic Carcinoma from Benign Prostatic Hyperplasia when serum Total Prostatic Specific Antigen level of 4 to10 ng/ml.