Association between biochemical and histopathological parameters in the clinical assessment of prostate tumors in a resource-limited setting in northern Cameroon

• Objective : This study assessed the role of biochemical parameters in diagnosing prostate cancer and benign prostatic hyperplasia (BPH). • Methodology : A questionnaire was used to gather sociodemographic data, followed by anatomical-pathological studies, including biopsies and biochemical marker measurements of PSA, alkaline phosphatase, urea, and creatinine. • Findings : Anatomical-pathological diagnoses indicated that 52% of cases were prostate cancer and 48% were BPH, with all participants exhibiting urinary obstruction. • Biochemical Insights : Pathological PSA levels were present in 65.6% of patients, with PSA effectively identifying prostatic tumors in over 50% of cases. Elevated creatinine and urea levels were found in 53.3% and 48.1% of patients, respectively. • Alkaline Phosphatase Levels : 30% of patients had pathological alkaline phosphatase levels ranging from 307 to 1918 IU/L. • Conclusion : In areas with limited access to anatomical-pathological services, biochemical parameters such as creatinine, urea, alkaline phosphatase, and PSA can be valuable diagnostic tools for prostate tumors. In low-resource settings, prostate tumors are often diagnosed at advanced stages because of limited access to imaging and histopathological services. Identifying routinely available laboratory biomarkers that could support clinical assessment and referral decisions is therefore of practical importance. This study evaluated the associations between selected biochemical parameters and histopathological diagnoses of prostate tumors in northern Cameroon. An analytical cross-sectional study was conducted among 90 men with suspected prostate tumors at the Islamic Clinic of Ngaoundere. Histopathological findings from prostate biopsy, including Gleason score, were correlated with serum prostate-specific antigen (PSA), creatinine, urea, and alkaline phosphatase (ALP). PSA was analyzed as both a continuous variable and a categorical variable using the standard 4 ng/mL threshold. Elevated creatinine was defined as ≥13 mg/L and urea as >0.5 mmol/L according to laboratory reference ranges. Prostate cancer accounted for 48% of cases and benign prostatic hyperplasia (BPH) for 52%. The median PSA level was 27 ng/mL (range: 3–1706 ng/mL). PSA levels >4 ng/mL were observed in 65.6% of patients and were more frequent in prostate cancer (70.2%) than in BPH (60.5%), without significant discrimination (p = 0.331). Elevated creatinine and urea were found in 53.3% and 48.1% of patients, respectively. PSA, creatinine, and ALP were significantly associated with prostate volume, whereas urea was not. ALP elevation (30%) was not associated with Gleason score. Considerable overlap in biochemical values was observed between malignant and benign conditions. Routinely available biochemical parameters provide complementary information but lack sufficient diagnostic accuracy to distinguish prostate cancer from BPH.