High-risk prostate cancer and very high PSA level: results of transrectal ultrasound-guided prostate biopsy in a Cameroonian population

Abstract

Aim: To study the indications, techniques, and results of transrectal ultrasound-guided prostate biopsy (TRUS-Bx) at two reference centres in Cameroon.

Materials and methods: A total of 232 patients underwent TRUS-Bx performed in two health reference centres in Yaoundé, Cameroon. The relationship between age, digital rectal examination (DRE), prostate-specific antigen (PSA) level, and adenocarcinoma of the prostate was evaluated.

Results: The mean age of the patients was 69.59 ± 7.57 years. Concerning the site of biopsy, we noted a frequency of 12 cores: two biopsies at the base, two biopsies at the middle part, and two biopsies at the apex of the prostate and each lobe. Total PSA levels ranged from 4 to 49 700 ng/ml with a mean PSA of 743.86 ± 3 806 ng/ml, and the median PSA was 45 ng/ml (15.09; 119). The main indication for prostate biopsy in our study was a PSA level > 4 ng/ml associated with abnormal DRE, particularly in 126 patients (54.31%). Out of 232 patients, 147 (63.36%) had adenocarcinoma of the prostate. High-risk prostate cancer was found in 131 patients (89.11%). The PSA associated with histopathology showed that PSA > 20 ng/ml is strongly associated with adenocarcinoma of the prostate (p = 0.001). Patients with abnormal DRE were 10 times more likely to have prostate cancer (odds ratio [OR] = 10.015, 95% confidence interval [CI] = 4.9233–20.3743, p = 0.001). Also, the likelihood of having prostate cancer was higher in men with PSA > 4 ng/ml (OR = 6.3465, 95% CI = 3.0450–13.2277, p = 0.001). The complication rate was 8.2%.

Conclusion: TRUS-Bx is a necessary diagnostic tool for prostate cancer. Minor complications can occur, and significantly high PSA levels and high-risk prostate cancer are key characteristics found in the Cameroonian milieu.