Detection of high-grade prostatic intraepithelial neoplasia with the five-region biopsy technique

Rosser, Charles J.; Broberg, Jeff; Case, Doug; Eskew, L. Andrew; McCullough, David L.

doi:10.1016/s0090-4295(99)00236-8

Cited by 21 publications

(10 citation statements)

References 9 publications

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“…This indicates that the prostate cancer risk is increased with the increase in the number of specimens found to have HGPIN on the 1 st biopsy. Our result also agreed with that of Bostwick et al [2], Abdel-khalek et al [23] and Rosser et al [27], However, it disagreed with studies that revealed lower prostate detection rate (De Nunzio et al [22], Kamoi et al [28] and Epstein & Herawi [29]) and other studies with higher prostate detection rate (Keetch et al [30] and Borboroglu et al [25]). …”

Section: Discussionsupporting

confidence: 75%

Is High Grade Prostatic Intraepithelial Neoplasia a Risk Factor for Prostate Cancer?—A Local Study

Al-Dabbagh¹,

Mohammad²,

Jaffal³

2018

OJU

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Objective: To determine the consequence of recognizing high grade prostatic intraepithelial neoplasia (HGPIN) & its extent on initial sextant prostatic biopsy then identifying its associated risk of finding prostate cancer on subsequent biopsy. Patients and methods: Seventy-one men were subjected to transrectal ultrasound guided sextant prostate biopsy due to elevated serum prostate specific antigen (S.PSA) > 4 ng /ml, an abnormal digital rectal examination (DRE) and/or transrectal ultrasound (TRUS) findings. The number, percentage, as well as bilateral and multifocal involvement of specimens positive for HGPIN were recorded in every patient. The percentage of cancer detected in these patients on repeat biopsy within 1 year of the initial biopsy was also recorded. Results: The mean age and mean S.PSA level of our patients was 59.9 years and 7.9 ng/ml respectively. Of the 71 patients studied, initial biopsy revealed that (32.4%) had benign prostatic hyperplasia (BPH), (36.62%) had carcinoma, (25.35%) had HGPIN and (5.63%) had chronic prostatitis. On repeat biopsy within 1 year of initial biopsy cancer of the prostate was detected in 33.3% of our patients who were diagnosed with HGPIN on 1 st biopsy. All of them had multifocal involvement on the initial biopsy. Conclusion: Recognizing HGPIN on 1 st biopsy (particularly multifocal involvement) is associated with great risk of prostate cancer development on subsequent biopsy, thus comprehensive follow-up of these patients is necessary.

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Section: Discussionsupporting

confidence: 75%

Is High Grade Prostatic Intraepithelial Neoplasia a Risk Factor for Prostate Cancer?—A Local Study

Al-Dabbagh¹,

Mohammad²,

Jaffal³

2018

OJU

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“…Thus, the number of cancers missed would be lower if more intensive biopsies were performed. Rosser et al [20] reported a 5-region biopsy technique, targeting the transition sextant as well as the far lateral and middle regions. Furthermore, earlier studies showed that the range of positive rates of extended biopsies was 25-51% [21,22] .…”

Section: Discussionmentioning

confidence: 99%

Free PSA/Total PSA Ratio Increases the Detection Rate of Prostate Cancer in Twelve-Core Biopsy

Yokomizo¹,

Miyoshi²,

Nakaigawa³

et al. 2009

Urol Int

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Background: In the present study, we compared 12- with 8-core biopsy in patients with prostate-specific antigen (PSA) levels of 4.0–20.0 ng/ml. We also examined whether the free/total (F/T) PSA ratio is useful for cancer detection in 12-core biopsy. Methods: A total of 419 men with PSA level between 4.0 and 20.0 ng/ml underwent transrectal ultrasound-guided transperineal needle biopsies of the prostate. Of these men, 235 underwent 8-core biopsy and 184 underwent 12-core biopsy. We compared the cancer detection rate between the 8- and 12-core biopsy groups by analyzing the PSA value, and especially the F/T PSA ratio. Results: The cancer detection rate in the 12-core group (35.9%) was significantly higher than in the 8-core group (23.8%). In cases of PSA level of 4.0–20.0 ng/ml with F/T PSA ratio less than 0.11, the cancer detection rate was 53.1% in the 12-core biopsy group. Performing 12-core biopsy resulted in a marked difference of cancer detection rate between men with F/T PSA ratio less than 0.11 and those with more than 0.12 in gray zone PSA (48.2% and 17.5%, respectively). Conclusions: Twelve-core biopsy can achieve a higher detection rate of prostate cancer than 8-core biopsy using F/T PSA ratio.

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“…Kamoi et al [13] reported that extended biopsy improved the detection rate in patients with HGPIN by only 10%, and Rosser et al [14] concluded that a five-region biopsy significantly increased the diagnosis of HGPIN over sextant biopsy, as 47% of cases were identified at the additional sites. Those authors reported that 33% of patients diagnosed with HGPIN were found to have cancer on subsequent five-region biopsy.…”

Section: Discussionmentioning

confidence: 99%

Predictors of prostate cancer on extended biopsy in patients with high‐grade prostatic intraepithelial neoplasia: a multivariate analysis model

2004

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DRE. Overall, 49 patients had a transurethral resection of the prostate (TURP). The cancerdetection rate on extended biopsy was correlated with risk factors using the chisquare test and multivariate analysis. RESULTSExtended biopsy detected prostate cancer in 30 of the 83 men (36%), with positive cores in only 20 sextant biopsy sites (67%), in only seven in additional sites (23%), and both in three (10%). Of the 21 patients who had repeat extended biopsy, four (19%) had cancers. There were two carcinomas in the 49 TURP specimens (4%). The PSA level, DRE and transrectal ultrasonography findings were not predictive of cancer in extended biopsies (chisquare test). Patient age, PSA density and the number of cores with HGPIN (all P < 0.001) had a significant effect on the cancerdetection rate, and multivariate analysis showed that all three were independent predictors of cancer. A logistic regression model was designed to predict the probability of cancer in extended biopsy, with an overall accuracy of 78%. CONCLUSIONExtended biopsy improved the cancer detection rate by 23% in patients with HGPIN. Patient age, PSA density and the number of cores with HGPIN were the only independent predictors of cancer. KEYWORDSprostatic intraepithelial neoplasia, prostate cancer, extended needle biopsy

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Detection of high-grade prostatic intraepithelial neoplasia with the five-region biopsy technique

Cited by 21 publications

References 9 publications

Is High Grade Prostatic Intraepithelial Neoplasia a Risk Factor for Prostate Cancer?—A Local Study

Is High Grade Prostatic Intraepithelial Neoplasia a Risk Factor for Prostate Cancer?—A Local Study

Free PSA/Total PSA Ratio Increases the Detection Rate of Prostate Cancer in Twelve-Core Biopsy

Predictors of prostate cancer on extended biopsy in patients with high‐grade prostatic intraepithelial neoplasia: a multivariate analysis model

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