Taux de PSA et Pathologies Prostatiques : une Analyse Histopathologique de 250 Pièces

RESUME Introduction. L’objectif de l’etude etait de determiner la correlation entre le taux de PSA et les aspects histopathologiques de la prostate. Materiel et Methodes. Il s’agit d’une etude transversale retroprospective et descriptive allant de Janvier 2012 a Juillet 2014. Tous les examens histologiques ont ete realises dans le Service d’anatomie et cytologie pathologiques du CHU Point G. Nos variables etaient les signes cliniques le taux serique de PSA et les resultats de l’examen anatomopathologique. Resultats. 250 patients ont ete colliges. La tranche d’âge 71-80 ans etait la plus representee (40,8%). La moyenne d’âge etait de 69,91 ± 8,93 ans avec des extremes allant de 40 et 102 ans. Le poids de la prostate a l’echographie a varie de 11 a 385 g. Le poids moyen de la prostate etait 71,73g. Le taux de PSA a varie entre 0 et 1952,5 ng/ml. Le taux moyen de PSA etait de 62,19 ng/ml. Des germes ont ete isoles dans 50,29% des cas. E Coli etait le germe le plus retrouve. L’adenomectomie de la prostate a ete pratiquee chez 179 patients (71,6%). Nous avons enregistre 73 cas d’adenocarcinome soit 29,2% des cas. Le taux de PSA etait significativement associe au type histologique (X²=25,473, p=0,000). Le score 8 a 10 a ete retrouve aussi bien sur les pieces a PSA normal qu’eleve. Il n’est donc pas lie a la valeur du taux de PSA (X²=2,818 ; p=0,244). Conclusion. Le taux de PSA total, considere comme un marqueur de depistage du cancer de la prostate, peut subir de nombreuses variations. ABSTRACT Introduction. Our goal was to the study the relation between blood PSA level and histopathological aspects of the prostate. Materials and methods. This was a cross sectional retroprospective and descriptive study from January 2012 to July 2014. All histological examinations were performed in the Department of Pathological Anatomy and Cytology of University Hospital at Point G. Our study variables were clinical features, blood PSA and pathology findings. Results. 250 patients were recruited. The 71-80 age group was the most represented at 40.8%. The average age was 69.91 ± 8.93 years with extremes ranging from 40 to 102 years. The prostate weight on ultrasound ranged from 11 to 385 g. The average weight of the prostate was 71.73g. The PSA level varied between 0 and 1952.5 ng / ml. The average level of PSA was 62.19 ng / ml. Germs were isolated in 50.29% of cases. E Coli was the most recovered germ. Prostatectomy was performed in 179 patients, or 71.6% of cases. We recorded 73 cases of adenocarcinoma, or 29.2% of cases. The PSA level is significantly associated with the histological type (X² = 25.473, p = 0.000). The score 8 to 10 was found on both normal and high PSA parts. It is therefore not related to the value of the PSA level (X² = 2.818, p = 0.244). Conclusion. The total PSA level, considered a marker for screening for prostate cancer, can undergo many variations.