Determination of Diagnostic Predictors of Prostate Cancer among Patients Attending Garissa County Referral Hospital, Kenya
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Date
2024-01
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Kenyatta University
Abstract
Prostate malignancy refers to a type of cancer that occurs on glandular cells of the prostate gland. It can also occur in other tissues when the cancer cells break away and travel through the blood vessels and lymphoid tissues. The latter is referred to metastatic Prostate Cancer. The disease is prevalent among old men with average age of 60 years. Prostate cancer needs early diagnosis to enable prevention of high mortality and morbidity associated with the disease. Early initiation of treatment is associated with reduced morbidity and mortality hence a need for easily accessible and reliable detection method. Prostatic specific antigen test is nonspecific hence delaying intervention while Confirmatory test (histopathology) is invasive and expensive. The study was aimed at investigating other predictors of prostate cancer in urine that can be an alternative to PSA or be interpreted together with PSA to offer an alternative confirmatory diagnosis instead of histopathology. Such predictors include sarcosine and zinc. Using a cross-sectional study design, all suspected cases of prostate cancer that were found during the study period based on clinical assessment were chosen. In plastic tubes, a volume of roughly 10 milliliters of midstream urine was collected. After centrifuging the urine and collecting the supernatant, zinc and sarcosine levels were measured. The levels of the urinary sarcosine and zinc was compared between study units who developed positive confirmatory test and those whose results are negative for confirmatory test. The collected numerical data was entered into a Microsoft Excel spreadsheet and then imported into the statistical package for social science (SPSS), where it was displayed as the mean, standard error of mean, and +/-standard deviation. The independent t test and analysis of variance (ANOVA) were used to compare the means and standard deviations across different age groups. Predictability of the analytes for the prostate cancer was determined using chi-square. Level of significance was set at 95% i.e., <0.05% for all comparisons. Prostate cancer patients' mean zinc concentration (0.98µmol/ml) was significantly lower than that of control participants (6.20µmol/ml; p<0.001). The age groups of prostate cancer patients showed that the zinc concentration used in the calorimeter to diagnose prostate cancer did not significantly differ. (p = 0.85). However, among control participants, there was no discernible variation in zinc concentration (p=0.11). Additionally, an ELISA test revealed that the sarcosine concentration (4.30±0.11 nmol/ml) in participants with prostate cancer was significantly higher than the control group's (0.47±0.06 nmol/ml) concentration (p<0.001). Using ELISA, there was no discernible difference in the age groups of the prostate cancer patients' sarcosine concentration (p=0.57). Sarcosine concentrations did not differ significantly between the age groups of the control subjects (p=0.17). The ELISA and calorimetric diagnosis results for sarcosine and zinc showed a significant difference between reality and the values for sensitivity, specificity, and predictability (p<0.001). The sensitivity of prostate cancer diagnosis using sarcosine ELISA and zinc calorimetric was 93.9% respectively while the specificity for both zinc and sarcosine was 100%. Both zinc and sarcosine recorded a positive predictive value of 100% and a negative predictive value of 93.5%. County governments need to allocate funds for diagnostic facilities to ease the burden of diagnosis. Future researchers should investigate other metabolites to supplement zinc and sarcosine in the diagnosis of prostate cancer.
Description
A Research Thesis Submitted in Partial Fulfillment of the Requirements for the Award of the Degree of Master of Science (Medical Laboratory Science) in the School of Health Sciences, Kenyatta University, January 2024
Supervisors:
1.Wachuka Gathigia Njoroge
2.Antony Omondi Radol