Author/Authors :
yeboah, f.a. komfo anokye teaching hospital - school of medical science - department of surgery, urology unit, Kumasi, Ghana , acheampong, e. kwame nkrumah university of science and technology (knust) - school of medical sciences - department of molecular medicine, Kumasi, Ghana , gyasi-sarpong, c.k. komfo anokye teaching hospital - school of medical science - department of surgery, urology unit, Kumasi, Ghana , aboah, k. komfo anokye teaching hospital - school of medical science - department of surgery, urology unit, Kumasi, Ghana , laing, e.f. kwame nkrumah university of science and technology (knust) - school of medical sciences - department of molecular medicine, Kumasi, Ghana , obirikorang, c. kwame nkrumah university of science and technology (knust) - school of medical sciences - department of molecular medicine, Kumasi, Ghana , frimpong, b.t. komfo anokye teaching hospital - school of medical science - department of surgery, urology unit, Kumasi, Ghana , amoah, g. komfo anokye teaching hospital - school of medical science - department of surgery, urology unit, Kumasi, Ghana , batu, e.n. komfo anokye teaching hospital - school of medical science - department of surgery, urology unit, Kumasi, Ghana , anto, e.o. kwame nkrumah university of science and technology (knust) - school of medical sciences - department of molecular medicine, Kumasi, Ghana , anto, e.o. royal ann college of health - department of medical laboratory technology, Kumasi, Ghana , amankwaah, b. kwame nkrumah university of science and technology (knust) - school of medical sciences - department of molecular medicine, Kumasi, Ghana
Abstract :
Introduction and objectives: Several existing models have been developed to predict positive prostate biopsy among men undergoing evaluation for prostate cancer (PCa). However, most of these models have come from industrialized countries. We therefore, developed a prostate disease nomogram model to provide a basis for predicting a prostate biopsy outcome by correlating clinical indicators and diagnostic parameters among Ghanaian men. Subjects and methods: The study was a hospital-based cross-sectional prospective one which was under- taken at the Department of Surgery (Urology Unit) Komfo Anokye Teaching Hospital (KATH) from December, 2014 to March, 2016. In all a total of 241 patients suspected of having a prostate disorder due based on an abnormal digital rectal examination (DRE) findings and, or elevated prostate specific antigen (PSA) level underwent Trans-Rectal Ultrasonography (TRUS) guided biopsy of the prostate. Stepwise logistic regression was used to determine the independent predictors of a positive initial biopsy. Age, prostatespecific antigen (PSA), digital rectal examination (DRE) status, prostate specific antigen density (PSAD), history of alcohol consumption and history of smoking findings were included in the analysis. Two nomo-gram models were developed that were based on these independent predictors to estimate the probabilityof a positive initial prostate biopsy. Receiver-operating characteristic curves (ROC) were used to assessthe accuracy of using the nomograms and PSA and PSAD levels for predicting positive a prostate biopsyoutcome.Results: Prostate cancer was diagnosed in 63 out of 241 patients (26.1%). Benign prostatic hyperplasiawas diagnosed in 172 (71.4%) of patients and the remaining 6 patients (2.48%) had chronic inflammation.Significantly elevated levels of PSA and PSAD were observed among patients with PCa compared to patientswithout PCa (p 0.05). Furthermore, it was observed that age, DRE, PSA, PSAD, history of smoking, andhistory of alcohol consumption were significantly independent predictors (p 0.05) of prostate cancer. Thearea under the receiver operating characteristic curve (AUC) of nomogram I and II were 87.3 and 84.8respectively which were greater than that of total PSA (AUC = 75.8) and PSAD (AUC = 77.8) alone forpredicting a positive initial prostate biopsyConclusion: We conclude that, nomograms offer a better and accurate assessment for predicting a positiveoutcome of prostate biopsies than the use of traditional tools of PSA, DRE and PSAD alone.
