Repeat prostate biopsies following diagnoses of prostate intraepithelial neoplasia and atypical small gland proliferation

Leite, Kátia Ramos Moreira; Mitteldorf, Cristina A.T.S.; Câmara-Lopes, Luiz H.

doi:10.1590/s1677-55382005000200007

Cited by 20 publications

(12 citation statements)

References 17 publications

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“…Some authors reported that HGPIN together with ASAP were predictive factors 7,13,14 . We suspected the coexistence of HGPIN and ASAP might be a good predictive factor for cancer detection.…”

Section: Discussionmentioning

confidence: 83%

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Atypical small acinar proliferation of prostate: Follow-up study of 114 patients

Lee

Choi

Yun

et al. 2011

Basic and Applied Pathology

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Background and aim: Atypical small acinar proliferation (ASAP) is defined as atypical foci suspicious for but not diagnostic of malignancy. ASAP is known as a strong predictive factor associated with prostate cancer. Because the diagnostic criteria for ASAP are subjective, objective diagnostic criteria were applied for ASAP as follows: (i) total loss of basal cells confirmed by immunohistochemistry and inconspicuous nucleoli; and (ii) a minute (≤500 micrometer in length) focus of atypical glands with total loss of basal cells and prominent nucleoli. Methods: To evaluate the cancer detection rate of ASAP diagnosed by objective diagnostic criteria, 114 patients initially diagnosed with ASAP were reviewed. Results: ASAP was noted in 2.17% of prostate biopsy cases. Eighty‐one patients were successfully followed up. Twenty patients (24.7%) were finally diagnosed as having adenocarcinoma by subsequent biopsy. According to the criteria, we subclassified ASAP into two groups: ASAP (not otherwise specified [NOS]) and ASAP (suspicious microscopic adenocarcinoma). ASAP (NOS) and ASAP (suspicious microscopic adenocarcinoma) showed significantly different cancer detection rates (20.3% vs 71.4%) at subsequent biopsies (P= 0.003). Sixteen patients underwent radical prostatectomy, and 13 cases (81.2%) were categorized as clinically significant prostate cancer. Conclusions: The presence of ASAP in needle biopsy was evaluated to be an important predictor of cancer.

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Section: Discussionmentioning

confidence: 83%

“…Some authors reported that HGPIN together with ASAP were predictive factors. 7,13,14 We suspected the coexistence of HGPIN and ASAP might be a good predictive factor for cancer detection. However, we failed to reveal a statistically significant correlation between the coexistence of HGPIN and cancer detection in the initial ASAP patients.…”

Section: Discussionmentioning

confidence: 99%

Atypical small acinar proliferation of prostate: Follow-up study of 114 patients

Lee

Choi

Yun

et al. 2011

Basic and Applied Pathology

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“…Only the series published by Mian et al contains data on extended biopsies, and they detected cancer in 13% of cases initially diagnosed as benign. 5 The results published by Singh et al 7 were based on 12 core biopsies, and they reported a cancer detection rate of 21%. In their study, however, they did not restrict their analysis to patients initially diagnosed as benign, and they also included HGPIN-positive cases, where HGPIN was the higher risk factor to find cancer in the rebiopsy.…”

Section: Discussionmentioning

confidence: 99%

“…A second biopsy detects cancer in up to 60% of patients. 7 , 8 HGPIN is the only pre-malignant lesion reported in 7% of needle biopsies, and rebiopsies detect cancer in 25–79% of cases after a diagnosis of HGPIN.…”

Section: Introductionmentioning

confidence: 99%

Prostate Cancer Detection at Rebiopsy After an Initial Benign Diagnosis: Results Using Sextant Extended Prostate Biopsy

Leite

Câmara-Lopes

Cury

et al. 2008

Clinics

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INTRODUCTION: Sextant prostate biopsy remains the standard technique for the detection of prostate cancer. It is well known that after a diagnosis of small acinar proliferation (ASAP) or high grade prostate intraepithelial neoplasia (HGPIN), the possibility of finding cancer is approximately 40% and 30%, respectively. OBJECTIVE: We aim to analyze follow-up biopsies on patients who initially received a benign diagnosis after exclusion of HGPIN and ASAP. METHODS: From July 2000 to December 2003, 1177 patients were submitted to sextant extended prostate biopsy in our hospital. The mean patient age was 65.5 years old, and the median number of fragments collected at biopsy was 13. HGPIN and ASAP were excluded from our study. We only considered patients who had a diagnosis of benign at the first biopsy and were subjected to rebiopsies up until May 2005 because of a maintained suspicion of cancer. RESULTS: Cancer was initially detected in 524 patients (44.5%), and the diagnosis was benign in 415 (35.3%). Rebiopsy was indicated for 76 of the latter patients (18.3%) because of a persistent suspicion of cancer. Eight cases of adenocarcinoma (10.5%) were detected, six (75%) at the first rebiopsy. Six patients were submitted to radical prostatectomy, and all tumors were considered clinically significant. CONCLUSION: Our data indicate that in extended prostate biopsy, the first biopsy detects more cancer, and the first, second, and third rebiopsies after an initial benign diagnosis succeed in finding cancer in 7.9% (6/55), 5.9% (1/15) and 20% (1/4) of patients, respectively

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“…The variation in the prevalence of this disease in different studies is mainly due to variations in patient demographics and the type of technique used for specimen sampling. In studies investigating the risk of cancer after an initial negative biopsy protocol, a repeat biopsy showed prostate cancer in 15–50% of cases [16].…”

Section: Discussionmentioning

confidence: 99%

Predictive value of prostatic adenocarcinoma after a negative prostate biopsy

et al. 2006

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OBJECTIVE To investigate the predictive value (PV) for all prostate cancers and for clinically significant cancer undiagnosed after a 10‐core biopsy protocol, as the 10‐core transrectal ultrasonography‐guided biopsy is considered the standard technique of prostatic biopsy due to its high rate of detection of prostatic adenocarcinoma. PATIENTS AND METHODS In all, 132 consecutive radical prostatectomy (RP) specimens, with their corresponding 10‐core biopsies, were reviewed. Cases with unilateral core involvement by prostate cancer were retained for study. Morphometric analysis was conducted on the biopsy‐negative hemi‐prostates to determine the PV of the biopsy protocol with respect to the size, position and clinical significance of the lesion. RESULTS In all, 70 resected prostates (RP) had unilateral core involvement by prostate cancer. In 38 cases, there was cancer in the biopsy‐negative hemi‐prostates (group 1); in the remaining 32 the hemi‐prostates were free of cancer (group 2). Group 1 was categorized by morphometric criteria. Specifically, 23 cases had one to eight foci of prostate cancer in the posterior nontransitional zone (NTZ) (group 1a), while 15 had two to six foci of prostate cancer in the transitional zone (TZ), or the anterior horn (AH) of the peripheral zone or the TZ and AH (group 1b). There were two cases with clinically significant prostate cancer in group 1a, and six in group 1b. CONCLUSIONS The PV of a negative five‐core biopsy protocol on a hemi‐prostate is 54% for prostate cancer and 11% for clinically significant prostate cancer. Most clinically significant prostate cancers were in the AH/TZ of the prostate.

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Repeat prostate biopsies following diagnoses of prostate intraepithelial neoplasia and atypical small gland proliferation

Cited by 20 publications

References 17 publications

Atypical small acinar proliferation of prostate: Follow-up study of 114 patients

Atypical small acinar proliferation of prostate: Follow-up study of 114 patients

Prostate Cancer Detection at Rebiopsy After an Initial Benign Diagnosis: Results Using Sextant Extended Prostate Biopsy

Predictive value of prostatic adenocarcinoma after a negative prostate biopsy

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