African Journal of Urology

, Volume 14, Issue 1, pp 15–22 | Cite as

Correlation of serum PSA and Gleason score in Nigerian men with prostate cancer

  • C. A. Okolo
  • O. M. Akinosun
  • O. B. Shittu
  • E. O. Olapade-Olaopa
  • L. I. Okeke
  • E. E. U. Akang
  • J. O. Ogunbiyi
Original Article



Prostate cancer is an important cause of morbidity and mortality worldwide. While the predisposing factors are not fully understood, African descent is an important risk factor, and prostate cancer has become the number-one cancer in Nigerian men. This was a retrospective study of the correlation between serum prostate specific antigen (PSA) and Gleason grade and score in patients of Nigerian descent.

Patients and Methods

The University College Hospital (UCH) Ibadan Cancer Registry was used to identify and quantify the incidence of prostate cancers occurring between 1998 and 2000. The histological slides of appropriate cases were reviewed to confirm the Gleason grade and score. The serum PSA values were retrieved from the patients' case notes and laboratory files. The data obtained were subjected to statistical analysis to look for associations and correlations.


The study included 67 men with prostate adenocarcinoma and PSA measurements who were diagnosed and treated at the UCH Ibadan between January 1998 and December 2000. There was a positive correlation between serum PSA and Gleason grade, as well as between serum PSA and Gleason score in our cohort of Nigerian African men with prostate cancer. PSA levels were significantly lower in patients with stage B disease than in patients with stage D disease.


Serum PSA is significantly higher in metastatic than in localized disease. Further studies are necessary to determine biomarkers that complement serum PSA and the Gleason grading system in the prognostication of prostate cancer in African patients.


Prostate cancer prostate specific antigen (PSA) Gleason score Nigeria 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    http://www.cancer/org/downoads/STT/Global_Cancer_Facts_and_Figures_2007.pdfGoogle Scholar
  2. 2.
    Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer. J. Clin. 2005 Mar–Apr. 55(2):74–108.PubMedCrossRefGoogle Scholar
  3. 3.
    Lubeck DP, Litwin MS, Henning JM, Stier DM, Mazonson P, Fisk R, et al. The CaPSURE database: a methodology for clinical practice and research in prostate cancer. CaPSURE Research Panel. Cancer of the Prostate Strategic Urologic Research Endeavor. Urology. 1996 Nov. 48(5):773–7.PubMedCrossRefGoogle Scholar
  4. 4.
    Sun L, Gancarczyk K, Paquette EL, McLeod DG, Kane C, Kusuda L, et al. Introduction to Department of Defense Center for Prostate Disease Research Multicenter National Prostate Cancer Database, and analysis of changes in the PSA-era. Urol. Oncol. 2001;6(5):203–9.CrossRefGoogle Scholar
  5. 5.
    Odedina FT, Ogunbiyi JO, Ukoli FA. Roots of prostate cancer in African-American men. J. Natl. Med. Assoc. 2006 Apr:98(4):539–43.PubMedGoogle Scholar
  6. 6.
    Gardner WA, Jr, Coffey D, Karr JP, Chiarodo A, Epstein J, McNeal JE, et al. A uniform histopathologic grading system for prostate cancer. Subcommittee on Diagnostic Nomenclature, Prostate Cancer Working Group, Organ systems Program. Hum. Pathol. 1988 Jan;19(1):119–20.PubMedCrossRefGoogle Scholar
  7. 7.
    Stamey TA, Yang N, Hay AR, McNeal JE, Freiha FS, Redwine E. Prostate-specific antigen asa serum marker for adenocarcinoma of the prostate. N. Engl. J. Med. 1987 Oct 8;317(15):909–16.PubMedGoogle Scholar
  8. 8.
    Nadler RB, Humphrey PA, Smith DS, Catalona WJ, Ratliff TL. Effect of inflammation and benign prostatic hyperplasia on elevated serum prostate specific antigen levels. J. Urol. 1995 Aug;154(2 Pt 1):407–13.PubMedCrossRefGoogle Scholar
  9. 9.
    Polascik TJ, Oesterling JE, Partin AW. Prostate specific antigen: A decade of discovery—what we have learned and where we are going. J. Urol. 1999 Aug;162(2):293–306.PubMedCrossRefGoogle Scholar
  10. 10.
    Guinan P, Bush I, Ray V, Vieth R, Rao R, Bhatti R. The accuracy of the rectal examination in the diagnosis of prostate carcinoma. N. Engl. J. Med. 1980 Aug 28;303(9):499–503.PubMedGoogle Scholar
  11. 11.
    Ogunbiyi JO, Shittu OB. Increased incidence of prostate cancer in Nigerians. J. Natl. Med. Assoc. 1999 Mar;91(3):159–64.PubMedGoogle Scholar
  12. 12.
    Abbiyesuku FM, Shittu OB, Oduwole OO, Osotimehin BO. Prostate specific antigen in the Nigerian African. Afr. J. Med. Med. Sci. 2000 Jun;29(2):97–100.PubMedGoogle Scholar
  13. 13.
    Kirby RS, Christmas TJ, Brawer M. Tumors markers in prostate cancer. In: Kirby RS, Christmas TJ, Brawer M, editors. Prostate cancer. 1st ed. Italy: Mosby; 1996. P.55–64.Google Scholar
  14. 14.
    Freeman VL, Coard KC, Wojcik E, Durazo Arvizu R. Use of the Gleason system in international comparsions of prostatic adenocarcinomas in blacks. Prostate. 2004 Feb 1;58(2):169–73.PubMedCrossRefGoogle Scholar
  15. 15.
    Gleason DF. Histological grading and clinical staging of prostatic carciooma. In: Tannenbaum M, editor. Urologic pathology: The prostate. Philadelphia: Lea & Febiger; 1977. P.171–98.Google Scholar
  16. 16.
    D'Amico AV, McGovern FT, Church PA, Tempany CMC. The staging of prostate cancer. In: Kantoff PW, Wishnow KL, Loughlin KR, editors: Prostate cancer: A multiisciplinary guide. 1st ed. Massachusetts. Blackwell Scientific; 1997. P.41–56.Google Scholar
  17. 17.
    Gleason DF, Mellinger GT. Prediction of prognosis for prostatic adenocarcinoma by combined histological grading and clinical staging. 1974. J. Urol. 2002 Feb;167(2) Pt 2): 953–8; discussion 959.PubMedCrossRefGoogle Scholar
  18. 18.
    Gleason DF. Histological grading of prostatic carcinoma. In: Bostwick DG, editor. Pathology of the prostate. New Y York: Churchill Livingstone; 1990. P.83–93.Google Scholar
  19. 19.
    Thompson IM, Chi C, Ankerst DP, Goodman PJ, Tangen CM, Lippman SM, et al. Effect of finasteride on the sensitivity of PSA for detecting prostate cancer. J. Natl. Cancer Inst. 2006 Aug 16;98(16):1128–33.PubMedCrossRefGoogle Scholar
  20. 20.
    Partin AW, Yoo J, Carter HB, Pearson JD, Chan DW, Epstein JI, et al. The use of prostate specific antigen, clinical stage and Gleason score to predict pathological stage in men with localized prostate cancer. J. Urol. 1993 Jul;150(1):110–4.PubMedGoogle Scholar
  21. 21.
    Herschman JD, Smith DS, Catalona WJ. Effect of ejaculation on serum total and free prostate-specific antigen concentrations. Urology. 1997 Aug;50(2):239–43.PubMedCrossRefGoogle Scholar
  22. 22.
    Moul JW, Sesterhenn IA, Connelly RR, Douglas T, Srivastava S, Mostofi FK, et al. Prostate-specific antigen values at the time of prostate cancer diagnosis in African-American men. JAMA. 1995 Oct 25;274(16):1277–81.PubMedCrossRefGoogle Scholar
  23. 23.
    Amayo A, Obara W. Serum prostate specific antigen levels in men with benign prostatic hyperplasia and cancer of prostate. East Afr. Med. J. 2004; Jan;81(1):22–6.PubMedGoogle Scholar
  24. 24.
    Iya D, Chanchani S, Belmonte J, Morris D, Glew RH, Van Der Jagt DJA. Prostate specific antigen in Africans: A study in Nigerian men. Nig J. Surg. Res. 2003;5(3):114–9.Google Scholar
  25. 25.
    The European Randomized study of Screening for Prostate Cancer(ERSPC). January 12, 2008;available at: Google Scholar
  26. 26.
    American Urological Association. Prostate cancer screening. 2006. Scholar
  27. 27.
    Efstathiou JA, Chen MH, Catalona WJ, McLeod DG, Carroll PR, Moul JW, et al. Prostate-specific antigen-based serial screening may decrease prostate cancer-specific mortality. Urology. 2006 Aug;68(2):342–7.PubMedCrossRefGoogle Scholar
  28. 28.
    Davidson P. and Gabbay J. Should mass screening for prostate cancer be introduced at the national level? WHO Regional Office for Europe Health Evidence Network (HEN), May 2004.Google Scholar

Copyright information

© Pan African Urological Surgeon’s Association (PAUSA) 2008

Authors and Affiliations

  • C. A. Okolo
    • 1
  • O. M. Akinosun
    • 2
  • O. B. Shittu
    • 3
  • E. O. Olapade-Olaopa
    • 3
  • L. I. Okeke
    • 3
  • E. E. U. Akang
    • 1
  • J. O. Ogunbiyi
    • 1
  1. 1.Department of PathologyUniversity of Ibada, University College HospitalIbadanNigeria
  2. 2.Department of Chemical PathologyUniversity of Ibadan, University College HospitalIbadanNigeria
  3. 3.Department of SurgeryUniversity of Ibadan, University College HospitalIbadanNigeria

Personalised recommendations