Assessment of prostate malignancy in participants with elevated PSA levels using transrectal ultrasound-guided prostate biopsy
DOI:
https://doi.org/10.61882/MEJNCD.1.1.3Keywords:
Prostate cancer, PSA, DRE, Transrectal ultrasound (TRUS)Abstract
Background: Prostate cancer is a common malignancy in older men and a major global health concern. This study aimed to assess prostate health and evaluate malignancy in individuals with elevated PSA levels and abnormal DRE findings.
Method: This cross-sectional study included 300 men supported by a local relief foundation and referred to Razi Hospital in 2016. Participants completed a questionnaire and underwent clinical evaluation, including digital rectal examination (DRE) and prostate-specific antigen (PSA) testing. DRE assessed asymmetry, nodules, firmness, and abnormal masses. PSA levels ≥3 ng/mL prompted further evaluation. Patients with urinary tract infection symptoms received antibiotics and repeat PSA testing. Persistently elevated PSA levels led to transrectal ultrasound-guided prostate biopsy, followed by histopathological confirmation. Univariate and multivariate regression analyses were used to identify factors associated with elevated PSA, with significance set at p < 0.05.
Results: PSA levels increased significantly with age, with participants aged ≥70 showing the highest mean values (8.2 ± 5.6 ng/mL) and more than twice the likelihood of having PSA ≥3 ng/mL (AOR = 2.18; p = 0.037). Dysuria and DRE-detected nodules showed increased odds but did not reach significance. Overall, 45 participants (15%) had PSA ≥3 ng/mL, of whom 25 underwent TRUS-guided biopsy. Histopathology confirmed malignancy in 9 cases (36%).
Conclusion: Age was the strongest predictor of PSA elevation. The borderline associations of dysuria and DRE nodules suggest potential clinical relevance, but larger studies are needed to clarify their predictive value.
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