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ORIGINAL ARTICLE
Year : 2019  |  Volume : 18  |  Issue : 2  |  Page : 143-148

Prostate-specific antigen and risk of bone metastases in west Africans with prostate cancer


1 Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana, West Africa
2 Department of Nuclear Medicine Service, Korle Bu Teaching Hospital; Department of Ghana Atomic Energy Commission, Accra, Ghana, West Africa
3 Department of Nuclear Medicine Service, Korle Bu Teaching Hospital, Accra, Ghana, West Africa
4 Department of Non Communicable Disease Control Programme, Ghana Health Service Headquarters, Accra, Ghana, West Africa
5 Department of Nuclear Medicine Service, Korle Bu Teaching Hospital, Accra, Ghana, West Africa; Department of Nuclear Medicine, University of Pretoria, Pretoria, South Africa; Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Netherland
6 Department of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana, West Africa

Correspondence Address:
Yaw Ampem Amoako
Department of Medicine, Komfo Anokye Teaching Hospital, P.O. Box 1934, Kumasi
West Africa
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DOI: 10.4103/wjnm.WJNM_38_18

PMID: 31040745

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We aimed to assess the relationship between bone scintigraphy findings and prostate-specific antigen (PSA) and Gleason score in a group of treatment naïve West Africans with prostate cancer. The age, PSA, and Gleason scores of 363 patients with prostate cancer were collected. Patients were risk stratified using the D'Amico criteria. Logistic regression was performed to assess the relationship between bone scan results and PSA and Gleason score. Receiver operating characteristics (ROC) analysis was used to determine the diagnostic reliability of the bone scan findings. Ninety of the 96 patients with metastases had high risk, and only 6 had low-to-intermediate risk disease (P = 0.0001). PSA (odds ratio [OR] 2.4 [95% confidence interval [CI] 1.5–3.8], P = 0.001) and GS (OR 2.2 [95% CI 1.5–3.1], P = 0.001) were independently predictive of the presence of metastases. ROC analysis revealed that PSA predicted the presence of metastases with an area under the curve of 0.72, and using a cut-off value of ≥20 predicted metastases with a sensitivity of 86.5% and specificity of 41.2%. A Gleason score of ≥7 had an 89.6% sensitivity and 34.8% specificity for bone metastases. Using a Gleason cutoff of ≥8, the sensitivity and specificity for predicting bone metastases were 54.2% and 71.5%, respectively. The area under the Gleason score ROC curve was 0.68. PSA and Gleason score are independent predictors of the presence of bone metastases in West Africans with prostate cancer.


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