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‫بسم الله الرحمن الرحيم‬

A Comparative Study Between


Prostatic Acid Phosphatase Enzyme
And Prostatic -Specific Antigen In
Diagnosis And Monitoring Of Prostate
Cancer
By/ Nassir hassan Mohammed elssayed
)Batch )25
Department of chemical pathology
:Supervisor
Mr. Abo bakr Hassan
Faculty of Medical Laboratory Science
University of Gezira
September 2006
Introduction
prostate is male's gland. it starts to develop
at twelfth week of fetal life under the
influence of androgenic hormones from the
fetal testis.
The normal size of prostate is 20g but can be
increased variably with malignancy but may
be 100- 200% larger in benign prostatic
hyperplasia )BPH).
Prostate gland has a sexual function, and it
forming secretion that may protect the lower
urinary tract and reproductive system from
the insult of pathogens.
-: Enlargement of prostate
• Benign prostatic hyperplasia )BPH).
• Prostate cancer.
• Diagnosis of prostate enlargement :-
• prostatic acid phosphates )PAP)
• prostate specific antigen )PSA)
• Biology of PSA .
• Protein Binding PSA.
• PSA clearance.
• Normal value:
• PAP : 1.7 U/L
• PSA : Up to 4 ng/ml .
• -clinical important :
Justification and objectives
• Justification
• 1. Prostate cancer is a serious disease and if is
not treated it can lead to death.
• 2. There is difficult in diagnosis and monitoring of
prostate cancer
• Objective
• 1. General objective
• To compare serum PSA level with that of serum
acid phosphates level.
• 2. Specific objective
• To measure serum PSA level
• To measure serum acid phosphates level
• To determine which of the tow measurement
should be recommended in diagnosis and
monitoring of prostate cancer.
Material & methods
• Study area and duration .
• Sample size .
• Equipment .
• Reagent .
• Methods for laboratory investigation
• Determination of serum prostatic acid
phosphates
• Principle:
Alpha-naftyle phosphate + H2O alpha-
naphtol + phosphate
Alpha-naphtol + fast Red TR AZO dye
• Determination of serum total PSA.
a) Added 200nl assay buffer to 20nl
stander/sample, vortex and added one
bead to them. Then incubated 2 hours on
rotator.
b) Added 2ml wash buffer and decanted the
solution )repeated twice).
c) Added 200nl 125I tracer solution. Incubated
on rotator about 20hours.
d) Then added 2ml wash buffer and
decanted the solution )repeated twice).
Result & discussion
Groups = Experimental
Table (1) Shows mean and std deviation of P.S A and P A P

Mean Std Deviation

Total PSA 191.5422 190.2668


PAP 6.64457 8.93169

Correlation Sig (2-tailed )

Total PSA&PAP 495 .000


Fig (1)
SHOWS MEAN & STD Deviation of PSA & PAP

std Devituon PSA PAP mean PSA PAP (Experimental)


(Experimental)
190.2668 250
200
191.5422
200
150
150

mean
Series1 100 Series1
std

100
50 50
8.93169 6.64457
0 0
psa pap psa pap
toal psa & pap toal psa & pap
GROUPS : CONTROL
Table (2)
Shows mean and std/ deviation of total PSA and PAP
Std Deviation
Mean
Total PSA 4.0714 .9604
PAP 1.00286 .49503

Correlation Sig (2-tailed )

Total PSA&PAP -.837 .001


Fig (2)
SHOWS MEAN & STD Deviation of PSA & PAP

mean PSA PAP (control) std Devituon PSA PAP


(control)
5
4.0714
4 1.2
0.9604
1
3
0.8
Series1 mean
0.49503 0.6

std
2 Series1
1.00286 0.4
1
0.2
0 0
psa pap
psa pap
toal psa & pap
toal psa & pap
Discussion
• This study done on 30 sample attended
institute of nuclear medicine molecular
Biology. 23 of them is experimental group
and 7 of them is group control. The age
between 50-90 years.
• The result obtained from the prosthetic
acid phosphates test and total PSA.
• The result shows in table )1) fig )1)
include the mean std deviation and
significant for sample tested group
experimental for PAP test and total PSA.
• mean of PAP)6.64457) the difference
is significant, the level of significant
is ).000)
• The result shows table )2) fig)2)
include the mean std deviation and
significant for sample tested group
control for PAP test and total PSA.
The mean of total PSA was )4.0714)
this high than mean of PAP )1.00286)
the difference is significant. The level
of significant is ).001)
Conclusion &-5
:recommendation
• Conclusion:
• There is significant difference
between acid phosphates estimation
compared to PSA estimation level in
diagnosis of prostate cancer.
• The serum PSA is moor accurate
and precise than serum PAP in
diagnosis and monitoring of prostatic
carcinoma.
:Recommendation

• PSA is time consuming and


expensive I recommend the test to
be done in a shorter time and with
minimal expensive.