An evaluation of TRUS guided FNAC as a diagnostic test for detection of prostatic carcinoma in correlation with total serum levels of PSA and zinc

This is prospective study conducted to evaluate the usefulness of the FNAC under Transrectal ultrasound guidance in correlation with seurnn PSA and serum zinc in establishing correct diagnosis of prostatic cancer. Cancer of the prostate is the most commonly diagnosed neoplasm in men in the world. Diagnosis of prostate cancer requires cytological or histological proof, which is most often obtained by FNAC or biopsy. Fine needle aspiration cytology is a safe and efficient diagnostic method in prostatic tumors. It is repeatable, almost painless procedure, easy to perform with high accuracy and low cost. Serum PSA has gained wide acceptance as a serum tumor marker in the management of prostate cancer and is potentially an important screening tool. PSA remains the best and most widely used tumor marker in urology today.
Ultrasound is not effective as a diagnostic tool by itself, because it cannot differentiate very well between benign inflammations and cancer, but the procedure may help to confirm an uncertain preliminary diagnosis and is useful as a guide for needle aspiration and in calculation of PSA density. Over a year period starting from Sept. 2002 to sept. 2003, 60 patients with symptoms and signs of prostatism were thoroughly evaluated in our study. 22(37%) patients had been diagnosed, as having prostatic cancer and the other 38 (63%) patients where found to have benign prostatic disease. The sensitivity and specificity for FNAC were 72.7% and 95% respectively. None of the PCA patients had serum PSA level less than 4 ng/ml and about 95.5% of all these patients had serum PSA higher than 10 mg/dl. 60.5% of BPH patients had normal serum PSA levels and only 18.4% of total BPH patients had serum PSA above 10 ng/ml. Out of the 26 cases positive for TRUS examination. 19 (73.1%) were PCA cases. The serum zinc levels in PCA patients were found to be significantly lower than that in BPH patients.