Prostate diseases in Lagos, Nigeria: a histologic study with tPSA correlation

Area of Science:

• Urology
• Pathology
• Oncology

Background:

• Prostate diseases represent a significant cause of morbidity in adult males.
• Histologic patterns and prevalence of prostatic lesions vary geographically.
• Understanding these patterns is crucial for effective diagnosis and management.

Purpose of the Study:

• To conduct a 10-year retrospective histologic study of prostate diseases in Lagos, Nigeria.
• To document the prevalence, histologic patterns, age distribution, and prostate-specific antigen (PSA) values of prostatic diseases.
• To analyze the characteristics of benign prostatic hyperplasia (BPH) and prostate cancer.

Main Methods:

• Retrospective analysis of prostatic biopsies from 1999 to 2008 at Lagos University Teaching Hospital.
• Inclusion of slides, paraffin blocks, case files, and histology request forms.
• Data collection on patient demographics, histologic diagnoses, and PSA levels.

Main Results:

• Prostatic biopsies constituted 3.6% of all biopsies; Benign Prostatic Hyperplasia (BPH) was the most common lesion (70.9%), typically affecting men aged 60-69.
• Malignant tumors accounted for 28.9% of biopsies, with adenocarcinoma being the predominant type (99.1%), often poorly differentiated and diagnosed in the 60-69 age group.
• Elevated PSA levels (≥50 ng/ml) were exclusively observed in malignant lesions, while lower levels were associated with both benign and malignant conditions.

Conclusions:

• Prostate cancer, particularly poorly differentiated adenocarcinoma, is a significant concern in Lagos.
• Elevated PSA levels in Nigerian males can indicate prostate cancer, BPH, or BPH with prostatitis.
• PSA should be integrated into a comprehensive diagnostic strategy rather than used as a standalone screening tool in this population.