الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Background: In the European Union, prostate cancer accounts for approximately 11% of all cancers and 9% of all cancers deaths. Adenocarcinoma of the prostate is now recognized as one of the most important medical problems facing the male population. It is the second most frequently diagnosed cancer and the sixth leading cause of cancer death in males all over the world. Detection strategies of prostate adenocarcinoma include the efficient use of the combination of digital rectal examination (DRE), serum prostate specific antigen (PSA) and transrectal ultrasound guided biopsy (TRUS). Aim of the work: is the evaluation of the role of complexed –prostate specific antigen (cPSA) in the detection of early prostate adenocarcinoma regarding specifity and sensitivity as single fronteline Test. Patients and Methods: A prospective cross sectional study to evaluate the role of complex PSA in the early detection of prostatic cancer was carried out in the department of urology, out patient clinics, Ainshams University hospital and Misr university for Science and Technology, in Cairo – Egypt from the period of January 2015 till March 2017. The study was approved by the ethical committee of the department of Urosurgery, Faculty of medicne, Ainshams University. A total of 120 patients were enrolled in the study. Only 90 Patients were eligible for entry into the study according to the following criteria: (1) Patients at least 50 years old, The cutoff of 50 years of age was used since patients younger than this age constitute only 1% of prostate cancer cases diagnosed each year. (2) Patients with no previous histologic proof of prostatic cancer, (3) tPSA between 2.5 and 20 ng/ml, (4) Absence of diseases or manipulations that could cause temporary elevation in tPSA e.g. prostatitis, TRUS- guided biopsy and acute retention of urine. Serum PSA Estimation After informed consent, blood samples were drawn for serum PSA estimation before any prostatic manipulation. If the serum PSA turned out to be < 2.5 or > 20 ng/ml the patient was excluded from the study. Results: In the current study, 90 Men were recruited. They were further subdivided into 3 groups according to their total PSA level group A (2.5-4) ng/ml), group B (4-10) ng/ml) and group C (10-20) ng/-ml. The studied men were with the following means and SD for age, group A (60.17 ± 5.77), group B (59.13 ± 6.20) and group C (61.20 ± 5.50), Prostatic volume (gm), group A (46.77 ± 10.49), group B (59.13 ± 6.20) and group C (48.40 ± 15.51), DRE group A 93.3% negative and 6.7% positive, group B 80% negative and 20% positive and group C 80% negative and 20% positive. Results showed there is no significance difference between the three groups.
Conclusion: cPSA assay as a single test leads to improvement in both sensitivity and specificity at range 2.5-4 ng/ml, at the same time it offers an economic advantage due to the use of a single analyte instead of two or more.