Prostate Tumors Diagnosis: Place of Fine Needle Aspiration in Congolese Patients

Abstract

Objective: To determine the kappa (κ) concordance coefficient between fine needle aspiration and serum prostatic antigen (PSA) coupled with digital rectal examination and prostatic ultrasound. Material and Methods: We conducted a cross-sectional study covering the period from January 1st to June 30th, 2018 in the city of Pointe-Noire. It is a study of 31 cases of prostate tumors in Congolese subjects at the General Hospital of Loandjili in Pointe-Noire of Congo Brazzaville. The clinical, biological, ultrasound and cytological aspects were the variables of the study. Results: The mean age was 71.06 years with extremes of 57 and 93 years. One patient had a family history of prostate cancer that was found at his brother’s house at the age of 52. Dysuria was the most represented sign in all of our patients. Suspicion of prostate cancer was the most commonly talked in digital rectal examination. Prostate specific antigen (PSA) was greater than or equal to 10 ng/ml in more 74% of our patients. 61.3% of our patients had a heterogeneous prostatic ultrasound. 48.3% of malignant tumors and 32.3% of benign tumors were found cytologically. The association between digital rectal examination and prostatic ultrasound was statistically significant (p ≤ 0.05) and good agreement was found between cytological diagnosis coupled with digital rectal examination and prostatic echostructure (0.6 ≤ κ ≤ 0.8). A low concordance between prostatic specific antigen (PSA) and cytological concordance was noted (0.2 ≤ κ ≤ 0.4). Conclusion: Prostatic tumors in Congo in their diagnostic particularities are dominated by malignant tumors with a large number of patients to watch. The fine needle aspiration is suitable for orientation examinations of prostatic tumors and can be performed by any doctor and provides us a fast, effective diagnostic orientation with a strong clinico-morphological correlation in our low incomes countries.