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"Latar belakang: Adenokarsinoma prostat adalah keganasan tersering kedua yang dialami pria di Indonesia. Skor Gleason digunakan untuk mengklasifikasi tingkat diferensiasi dari tumor sedangkan menghitung kadar PSA digunakan sebagai salah satu cara untuk mendiagnosis kanker prostat.Tujuan: Riset ini bertujuan untuk mengetahui korelasi antara skor Gleason dengan kadar PSA pada pasien adenokarsinoma prostat di departemen Patologi Anatomik RSCM. Metode Penelitian: Data dikumpulkan dari 77 sampel yang didapat dari form pemeriksaan hasil diagnosis pasien adenokarsinoma prostat tahun 2011 sampai 2014 di arsip Department Patologi Anatomik RSCM. Data diolah menggunakan analisis uji korelasi Kendall Tau-b di program SPSS 20.Hasil: Sebagian besar pasien datang dengan skor Gleason yang sudah tinggi skor Gleason >7. Nilai PSA terkecil yang didapat dari arsip departemen Patologi Anatomik sebesar 2,73 ng/ml, nilai tertinggi mencapai 7100 ng/ml. Nilai rata-rata PSA meningkat dengan meningkatnya skor Gleason. Rata-rata nilai PSA dari skor Gleason 6, 7, 8, 9, dan 10 adalah 46,641 ng/ml, 63,935 ng/ml, 231,762 ng/ml, 542,146 ng/ml, and 1044,348 ng/ml p = 0,003, r = 0,254. Kesimpulan: Terdapat korelasi yang lemah antara skor Gleason dengan nilai PSA pada pasien adenokarsinoma prostat di Department Patologi Anatomik RSCM. Nilai PSA meningkat seiring meningkatnya skor Gleason.

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Background: Prostatic adenocarcinoma is the second most frequent malignancies occur in men in Indonesia. Gleason score is used to classify the grading of the tumor and PSA is used as one of diagnostic tools for prostate cancer.

Aim: To identify the correlation between Gleason score and PSA level in patients with prostate adenocarcinoma at Department of Anatomical Pathology Cipto Mangunkusumo Hospital. Method The data was obtained from 77 samples taken from request forms from patients with prostatic adenocarcinoma from 2011 to 2014 in the archive of Department of Anatomical Pathology and analyzed using Kendall Tau b rsquo s Rank Correlation in SPSS 20.

Result: Most patient came with high Gleason Score Gleason score 7 . The minimum PSA level obtained from the arcieve in Department of Anatomical Pathology is 2.73 ng ml and the highest value reached up to 7100 ng ml. The average PSA level increased with the Gleason score. Gleason score 6, 7, 8, 9, and 10 has the average PSA level of 46.641 ng ml, 63.935 ng ml, 231.762 ng ml, 542.146 ng ml, and 1044.348 ng ml respectively p 0.003, r 0.254.

Conclusion: There is statistically weak significant correlation between Gleason score and PSA level in patients with prostatic adenocarcinoma in Department of Anatomical Pathology Cipto Mangunkusumo Hospital. PSA increased as the Gleason score increase."

"Telah diketahui bahwa estrogen dan reseptor estrogen sangat berpengaruh pada sistem reproduksi, perkembangan payudara dan pembentukan kanker pada wanita. Namun efek estrogen pada sistem reproduksi pria serta mekanisme estrogen pada terjadinya kanker pada pria, khususnya kanker prosat masih belum jelas. Dari sekumpulan penelitian didapatkan kemungkinan estrogen dan reseptor estrogen berperan pada terjadinya kanker pada pria, terutama kanker prosat Reseptor estrogen dapat ditemukan pada stroma dan sel epitel prostat.

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It is known that estrogen and estrogen receptors have a great influence on the reproductive system, breast development and the formation of cancer in women. However, the effect of estrogen on the male reproductive system and the mechanism of estrogen in the occurrence of cancer in men, especially prostate cancer, is still unclear. From a set of studies, it is possible that estrogen and estrogen receptors play a role in the occurrence of cancer in men, especially prostate cancer Estrogen receptors can be found in the stroma and epithelial cells of the prostate."

"Latar belakang: Adenokarsinoma prostat merupakan salah satu jenis kanker yang paling banyak didiagnosis pada laki-laki di seluruh dunia, dengan mayoritas pasien berusia di antara 60 ndash; 80 tahun. Usia adalah salah satu faktor risiko yang paling berperan, dan diperkirakan mempunyai andil dalam perkembangan penyakit ini.Tujuan: Untuk menentukan korelasi antara usia dengan skor Gleason pada pasien dengan adenokarinoma prostat.Metode Data mengenai usia dan skor Gleason diperoleh dari 101 sampel yang diambil dari lembar permintaan pemeriksaan pasien dari tahun 2011 sampai 2014, di Departemen Patologi Anatomik, Rumah Sakit Cipto Mangunkusumo. Analisis statistik Kendall's tau-b digunakan untuk menentukan korelasi.Hasil: Usia rata-rata pasien adenokarsinoma prostat pada penelitian ini adalah 67,87 tahun dan kebanyakan pasien memiliki skor Gleason 9 48 pasien . Pada uji korelasi antara usia dan skor Gleason pasien didapat nilai p = 0,012 dan r = -0,193. Pasien di bawah 65 tahun memiliki rata-rata skor Gleason 8,588, pasien di atas 65 tahun tahun memiliki rata-rata skor Gleason 8,239. Pada uji non parametrik Mann ndash; Whitney didapat nilai p = 0,009.Kesimpulan: Terdapat korelasi sangat lemah antara usia dengan skor Gleason pada pasien dengan adenokarsinoma prostat. dengan pasien muda cenderung memiliki skor Gleason yang lebih tinggi.

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Background: Prostatic adenocarcinoma is one of the most common cancers diagnosed in men worldwide, with most patients being 60 ndash 80 years old. Age is one of the significant risk factors of the disease's development and progression.

Aim: To determine the correlation between age and Gleason score in patients with prostatic adenocarcinoma.

Methods: Data in regard to age and Gleason score of patients with prostatic adenocarcinoma were obtained from 101 samples from patients'request forms in 2011 to 2014, in Department of Anatomical Pathology, Cipto Mangunkusumo Hospital. Kendall's tau b statistical analysis was used to determine the correlation.

Results Mean age of patients in prostatic adenocarcinoma in this study is 67.87 years old, and most patients have Gleason score of 9 48 patients. On statistical analysis to determine correlation between age and Gleason score, we acquire p value of 0.012 and r value of 0.193. Patients below 65 years old have average Gleason score of 8.588, patients above 65 years old have average Gleason score of 8.239. On Mann ndash Whitney non parametric test, we acquire p value of 0.009.

Conclusion There was a very weak correlation between age and Gleason score in patients with prostatic adenocarcinoma with younger patients tend to have higher Gleason score."

"Pendahuluan: Sejak tahun 70-an hingga sekarang, skor Gleason merupakan parameter penting pada penatalaksanaan kanker prostat. Biopsi prostat yang umum dipakai untuk membedakan antara kondisi jinak dan ganas semakin menjadikan skor Gleason berperan penting dalam menentukan tatalaksana selanjutnya. Meskipun demikian, terdapat diskrepansi antara skor Gleason yang diambil secara biopsi dan paskaoperasi. Tujuan: Untuk menentukan perbedaan skor Gleason sebelum dan setelah dilakukan prostatektomi radikal, dan untuk mencari faktor-faktor yang berperan dalam peningkatan skor Gleason. Metode: Dilakukan evaluasi laporan patologi dari spesimen prostat yang didapatkan secara biopsi dan paska prostatektomi radikal antara Januari 2004 sampai Desember 2013. Kriteria eksklusi dari studi ini adalah laporan-laporan yang tidak mencantumkan skor Gleason ataupun diagnosis selain adenokarsinoma prostat. Hasil: Studi ini menginklusikan 36 subjek dengan adenokarsinoma prostat yang telah menjalani prostatektomi radikal. Skor Gleason 6 merupakan skor tersering yang dilaporkan pada biopsi, sedangkan skor Gleason 7 merupakan skor tersering yang dilaporkan pada spesimen prostatektomi radikal. Diantara subjek, 58,3% (n=21) memiliki perbedaan antara skor Gleason biopsi dan prostatektomi radikal; 11,1% (n=4) memiliki penurunan dan 47,2% (n=17) mengalami peningkatan. Dengan menggunakan analisis statistik dijumpai bahwa rendahnya densitas PSA (PSAD) memiliki korelasi dengan likelihood peningkatan (r=0,658, p=0,006). Kesimpulan: Sebagian besar pasien memiliki perbedaan antara skor Gleason hasil biopsi dan paskaoperasi dimana terlihat kecenderungan peningkatan dibandingkan dengan penurunan skor. PSAD merupakan faktor yang berkorelasi dengan peningkatan skor Gleason.

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Introduction: Since its introduction in mid 70 until now, Gleason Score is an important parameter in the treatment of prostate cancer. The common practice of prostate biopsy to differentiate between malignant and benign condition of the prostate, hence makes Gleason score plays important role in determine the next step of treatment. Still there is a discrepancy between Gleason score taken from biopsy and postoperatively.

Aim: To determine the Gleason score difference before and after radical prostatectomy, and to find factors that has a role in the upgrading of Gleason score.

Methods: We evaluated pathology reports of prostate specimens obtained from biopsy and after radical prostatectomy between January 2004 until December 2013. Exclusion criteria of this study were reports that failed to mentioned Gleason score or a diagnosis apart from adenocarcinoma of the prostate.

Results: This study enrolled 36 subjects with adenocarcinoma of the prostate who underwent radical prostatectomy. Gleason score 6 was the most reported score in initial biopsy while Gleason score 7 was the most reported in radical prostatectomy specimen. Among the subjects 58.3% (n=21) had diferrences of Gleason score between biopsy and radical proistatectomy; 11.1% (n=4) had a downgrading and 47.2% (n=17) had an upgrading. Using statistical analysis we found out that low prostate specific antigen densities (PSAD) had correlation with upgrading likelihood (r 0.658, p = 0.006).

Conclusion: More than half of our patient had differences between biopsy Gleason score and postoperative scores with majority showed a likelihood of upgrading rather than downgrading, PSAD was the factors that correlates with upgrading in Gleason score."

"Objective: Carcinogenesis of adenocarcinoma of the prostate occurs due to dysregulation of zinc level within the cells. Intracellular zinc molecules influx is regulated by a transporter protein ZIP1, whose non-presence is predicted to inhibit apoptosis, thus leads to the development of prostate adenocarcinoma. Methods: This study was aimed to analyze the correlation of ZIP1 and Caspase-3 expression in prostate adenocarcinoma on its grading as represented by Gleason Score. This was a cross-sectional, retrospective analytical study on 31 formalin-fixed, paraffin-embedded tissue that meets inclusion criteria. The specimen was stained using the immune-histochemistry technique for ZIP1 and Caspase-3. Protein expression of each case was counted using ImageJ analysis. Gleason score was acquired as secondary data from the cases?s reports. The correlation of their expression with respect to Gleason score was analyzed with Pearson?s correlation using SPSS 11.5. Results: Mean expression level of ZIP1 and Caspase-3 in prostate adenocarcinoma were 35% and 33%, respectively. There was a significantly positive correlation between ZIP1 and Caspase-3 expression (r = 0.379; p = 0.018). However, their correlation was stronger in intermediate-grade group (r = 0.73; p = 0.01) and the correlation was much weaker in high-grade group (r = 0.04; p = 0.48). Conclusions: There was a positive correlation between ZIP1 and Caspase-3 expression in prostate adenocarcinoma.;"

"Objective: Carcinogenesis of adenocarcinoma of the prostate occurs due to dysregulation of zinc level within the cells.Intracellular zinc molecules influx is regulated by a transporter protein ZIP1, whose non-presence is predicted to inhibitapoptosis, thus leads to the development of prostate adenocarcinoma. Methods: This study was aimed to analyze thecorrelation of ZIP1 and Caspase-3 expression in prostate adenocarcinoma on its grading as represented by GleasonScore. This was a cross-sectional, retrospective analytical study on 31 formalin-fixed, paraffin-embedded tissue thatmeets inclusion criteria. The specimen was stained using the immune-histochemistry technique for ZIP1 and Caspase-3.Protein expression of each case was counted using ImageJ analysis. Gleason score was acquired as secondary data fromthe cases’s reports. The correlation of their expression with respect to Gleason score was analyzed with Pearson’scorrelation using SPSS 11.5. Results: Mean expression level of ZIP1 and Caspase-3 in prostate adenocarcinoma were35% and 33%, respectively. There was a significantly positive correlation between ZIP1 and Caspase-3 expression(r = 0.379; p = 0.018). However, their correlation was stronger in intermediate-grade group (r = 0.73; p = 0.01) and thecorrelation was much weaker in high-grade group (r = 0.04; p = 0.48). Conclusions: There was a positive correlationbetween ZIP1 and Caspase-3 expression in prostate adenocarcinoma."

"Latar belakang: Kanker prostat merupakan tumor ganas terbanyak ketiga pria di dunia. Penyebabnya dipengaruhi faktor usia, genetik, ras, hormonal, diet dan lingkungan. Kanker prostat dapat mengalami Neuroendocrine Differentiation NED , meningkat pada kanker prostat berdiferensiasi buruk terutama yang tidak merespon baik terhadap terapi hormonal. NED akan menentukan prognosis dan pemilihan alternatif terapi.Tujuan: Mengetahui perbedaan ekspresi Chromogranin A CgA pada adenokarsinoma prostat berdiferensiasi baik, sedang dan buruk serta kaitannya dengan derajat keganasan berdasarkan grading tumor yang diharapkan dapat menentukan prognosis dan pemilihan alternatif terapi.Metode: Studi potong lintang terhadap jaringan biopsi yang difiksasi formalin, diletakkan dalam parafin dari pasien dengan adenokarsinoma prostat berdiferensiasi baik, sedang dan buruk. Sampel penelitian dipulas dengan pewarnaan imunohistokimia CgA, diidentifikasi dan dianalisa hubungan ekspresi CgA berdasarkan usia, diagnosis histopatologik, grade groups, skor Gleason dan kadar PSA.Hasil: Ekspresi CgA positif dengan median 40 0,4-100 banyak terjadi pada kelompok usia 7. Ekspresi CgA positif dengan median 35,4 0,4-88,6 banyak terjadi dengan kadar PSA > 52,4 ?g/ml. Didapatkan hubungan bermakna antara ekspresi CgA dengan diagnosis histopatologik, grade groups dan skor Gleason p = 0, 006;p = 0,021;p = 0,006 . Tidak didapatkan hubungan bermakna antara ekspresi CgA dengan usia dan kadar PSA p = 0,412;p = 0.969 . Kesimpulan: Terdapat kecenderungan positivitas ekspresi CgA lebih banyak terjadi pada kasus adenokarsinoma prostat berdiferensiasi buruk dengan grade tinggi, yang dapat mempengaruhi prognosis dan pemilihan alternatif terapi.Kata kunci: Ekspresi Chromogranin A, adenokarsinoma prostat, grade groups, skor Gleason.

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Background Prostate cancer is the third most common malignant tumor in men worldwide. Predisposing factors of prostate cancer are influenced by age, genetics, race, hormonal, diet and environment. Prostate cancer may undergo Neuroendocrine Differentiation NED , and it found to be increase in poorly differentiated type of prostate cancer, especially who do not respond well to hormonal therapy. NED will determine the prognosis and selection of therapeutic alternatives.Objective To determine differences in expression of Chromogranin A CgA in prostate adenocarcinoma well, moderately and poor differentiated and its relationship to the tumour grading, and its effect on determining prognosis and selecting therapeutic alternatives.Methods A cross sectional study conducted to formalin fixed paraffin embedded biopsy tissue that are taken from a patient with prostate adenocarcinoma well, moderately and poor differentiated. The sample are immunohistochemical stained with CgA, identified and analyzed. The reviewed and analized it rsquo s relationship to the parameter on age, histopathological diagnosis, grade groups, Gleason score and PSA level.Results Chromogranin A positive expression with median 40 0.4 100 was found in the age 7 of prostate adenocarcinoma. CgA positive expression with median 35.4 0.4 88, 6 was found with PSA level 52.4 g ml. There were a significant difference between CgA expression with histopathological diagnosis, grade groups and Gleason score p 0, 006 p 0.021 p 0.006 . There were no significant difference between CgA expression with age and PSA level p 0.412 p 0969 .Conclusion There is a statistically significant difference of CgA expression with histopathologycal diagnosis and grade groups of prostate adenocarcinoma that reflect a worse prognosis in CgA positive group among prostate adenocarcinoma, which will need alternative therapies beside widely used hormonal therapy.Keywords Expression Chromogranin A, prostate adenocarcinoma, grade groups, Gleason score."

"Pendahuluan: Docetaxel telah menunjukkan efek dalam pengobatan CRPC biladigunakan sebagai monoterapi atau dalam kombinasi dengan kemoterapi lainnya.Banyak penelitian telah menunjukkan korelasi penurunan Prostate Specific Antigen PSA dengan kesintasan pasien CRPC yang mendapatkan terapi Docetaxel. Penelitian-penelitian sebelumnya juga menyatakan adanya korelasi antara volumeprostat, Gleason Score, dan insiden metastasis dengan nilai PSA. Penelitian inibertujuan untuk menganalisis hubungan antara volume prostat, Gleason Score, danada tidaknya metastasis terhadap penurunan PSA sebagai prediktor respon padapasien CRPC yang mendapatkan Docetaxel. Metode: Penelitian analitik retrospektif dengan mengunakan data rekam medisRumah Sakit Umum H. Adam Malik Medan yang dilaksanakan pada periode 1Januari 2016-31 Juli 2016. Populasi dan sampel dalam penelitian ini adalah seluruhpasien dengan penderita CRPC yang telah menjalani kemoterapi Docetaxelsebanyak 10 siklus. Pasien yang memenuhi kriteria inklusi, dipaparkan denganvariabel independen Taksiran Besar Prostat, Skor Gleason, Status Metastase danvariabel dependen perubahan PSA. Hasil: Sebanyak 8 pasien yang memenuhi kriteria inklusi yang berusia rata-rata 65tahun dengan taksiran berat prostat 38,6 gram dengan skor gleason ≥ 7 sebanyak 6 orang 75 sedangkan.

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Introduction: Docetaxel has shown efficacy in CRPC treatment as monotherapy or combination therapy. Previous research showed a correlation between prostat volume, Gleason score, and metastases with PSA value. This study aimed toanalyze the correlation between prostat volume, gleason score, and metastases withPSA value decrement as a response predictor in CRPC patients who receiveDocetaxel.

Methods: This is a retrospective analytic research, using data in medical recordsin RSU H. Adam Malik Medan, conducted on January 1 July 31 2016. Populationand samples in this research are patients with CRPC who already received 10 cyclesof Docetaxel chemotherapy. Patients that fulfilled the inclusion criteria areanalyzed with dependent and independent variables estimated prostate volume,Gleason Score, and metastatic status.

Results: Total of 8 patients who fulfilled inclusion criteria were averagely 65 yearsold, estimated prostate weight of 38.6 gram, and 6 people had Gleason score ≥ 7 75 and 2 people had Gleason score "

"ABSTRAKLatar belakang : Insiden Adenokarsinoma di RSCM meningkat pada periode 2001-2006 dibanding periode sebelumnya 1995-2000 . Banyak penderita yang resisten terhadap pengobaan hormonal. Resistensi ini diduga akibat sel tumor mengalami transformasi Neuroendokrin. Akan dilakukan penelitian untuk melihat ekspresi Androgen Receptor AR dan Chromogranin A CgA pada adenokarsinoma prostat di RSCM tahun 2011-2015.Tujuan : Membuktikan korelasi ekspresi AR dan CgA dengan derajat keganasan.Metode : Studi potong lintang analitik terhadap 70 kasus adenokarsinoma prostat di departemen PA FKUI/RSCM tahun 2011-2015. Kasus dipulas imunohistokimia AR dan Cg A serta dilakukan interpretasi hasil. AR dinilai prosentase positivitasnya pada inti epitel dan stromal. CgA dinilai prosentase positivitasnya pada sitoplasma. Uji korelasi dilakukan untuk melihat kemaknaan dan kekuatan korelasi antar variabel terikat.Hasil : Karakteristik sampel usia 47,1 >70 tahun; diferensiasi histopatologik/skor gleason 42,9 buruk/>7, grade group 28,6 grade5 dan PSA 64,3 dalam rentang 11-100ng/ml. Ekspresi CgA berkorelasi negatif lemah dengan ekspresi AR epitel r=-0,288;p=0,016 . Ekspresi CgA tidak berkorelasi dengan ekspresi AR stromal p=0,886 . Terdapat hubungan bermakna ekspresi AR epitel dengan grade group p=0,003 . Tidak terdapat hubungan bermakna ekspresi AR epitel dengan usia, diferensiasi histopatologik/skor gleason dan PSA. Ekspresi CgA berhubungan bermakna dengan diferensiasi histopatologik/skor gleason dan grade group p=0,018;p=0,038 . Tidak terdapat hubungan bermakna ekspresi CgA dengan usia dan PSA. Ekspresi AR stromal tidak berhubungan bermakna dengan usia, diferensiasi histopatologik, grade group, skor gleason, maupun PSA.Kesimpulan : Terdapat korelasi yang lemah antara AR dan CgA sehingga pulasan AR dan CgA dapat dipakai untuk pemilihan terapi.

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ABSTRACT Background Prevalence of prostate adenocarcinoma doubled in 2001 2006 compared to 1995 2000 in RSCM. Many patients resistant to hormonal treatment. This resistance is thought to be due to tumor cells undergoing neuroendocrine transformation. Study will be conducted to analyze the expression of Androgen Receptor AR and Chromogranin A CgA in prostate adenocarcinoma at RSCM in 2011 2015. Objective To prove correlation of expression of AR and CgA with degree of malignancy. Methods A cross sectional study was carried out on 70 cases of prostate adenocarcinoma in department of Anatomic Pathology FKUI RSCM from 2011 2015. AR expressed in stromal and epithelial nuclei, CgA expressed in cytoplasm. Statistical tests used to discover significance and correlation between the dependent variables. Results Most samples are more than 70 years old 47,1 , has poor histologic gleason score 42.9 , are in clinical grade 5 28.6 , and has PSA score range between 11 100 ng ml. CgA expression negatively correlates to epithelial AR expression r 0,288 p 0.016 , while no correlation are found between CgA expression and stromal AR expression p 0.886 . There is significant difference between epithelial AR expression with grade group p 0.003 , but not with age, histopathologic differentiation Gleason score and PSA. There are significant difference between CgA expression and histopathologic differentiation grade group and Gleason score p 0.018 p 0.038 , but not with age and PSA. No significant difference observed between stromal AR expression with age, histopathologic differentiation gleason score, grade group or PSA. Conclusion There rsquo s a weak correlation between AR and CgA so that AR and CgA expression can be used for the selection of therapy. "

"Tujuan: Mengidentifikasi korelasi dan insiden metastasis tulang pada pasien kanker prostat dengan Gleason Score (GS) dan Prostate Specific Antigen (PSA) yang rendah. Material dan Metode: Studi deskriptif retrospektif pada pasien kanker prostat di Rumah Sakit Cipto Mangunkusumo periode 2006-2011. Ada 478 pasien dengan kanker prostat. Pasien kanker prostat dengan PSA rendah, telah menjalani pemeriksaan histopatologi, dan bone scan diikutsertakan dalam studi, sehingga didapatkan 358 pasien sebagai subjek penelitian. Nilai PSA diukur dengan sandwich electrochemiluminescent immunoassay. Pemeriksaan histopatologi diklasifikasikan menurut sistem grading Gleason dan dibagi menjadi 3 kategori: diferensiasi baik (GS ≤6), diferensiasi sedang (GS 7), dan diferensiasi buruk (GS 8-10). Bone scan dikerjakan dengan dengan agen radiofarmaka (Tc99m methylenendiphosphonate) dan kemudian gambar ditangkap dengan kamera gamma. Hasil: Rerata usia 67.52±7.8 tahun, rerata GS 7.7±1.3, dan median PSA adalah 56.9 (rentang: 0,48-17000 ng/mL). Ada 11 orang pasien (3,0%) dengan bone scan positif dengan PSA <20 ng/mL dan GS<8. Lebih lanjut, ada 2 pasien (0,6%) dengan GS≤6 dan PSA<10 ng/mL memperlihatkan metastasis ke tulang. Kesimpulan: Pada studi ini, ada sebagian kecil pasien mengalami metastasis tulang dengan PSA (PSA<10 mg/mL) dan GS (GS≤6) rendah.

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Objective: This study was aimed to identify correlation and incidence of bone metastases in prostate cancer patient with low Gleason Score GS and Prostate Specific Antigen PSA.

Materials and Methods: A descriptive restrospective study to patients with prostate cancer in Cipto Mangunkusumo Hospital in 2006 2011 There were 478 patient with prostate cancer Patients with prostate cancer who had PSA value histological examination and bone scan were included in the study resulting in 358 eligible patients for the study PSA value was measured using the sandwich electrochemiluminescent immunoassay Histological examination was graded according to Gleason's grading system and divided into 3 category well differentiated GS le 6 moderately differentiated GS 7 and poorly differentiated GS 8 10 Bone scan was done using radiopharmaceuticals agent Tc 99m methylenen diphosphonate and then the image was captured using gamma camera

Results: The mean age was 67 52 7 8 mean GS was 7 7 1 3 and median PSA was 56 9 range 0 48 17000 ng mL There were 11 patients 3 0 with positive bone scan with PSA<20 ng/mL and GS<8. Furthermore, there were 2 patients (0.6%) with GS≤6 and PSA<10 ng/mL showed bone metastasis.

Conclusion: In our study, there were still small percentage of patients with bone metastasis even when lower value of PSA (PSA<10 ng/mL) and GS (GS≤6) were applied."