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

Abdelkhalek, Mohamed; El‐Baz, Mahmoud; Ibrahiem, El-Houssieny

doi:10.1111/j.1464-410x.2004.04996.x

Cited by 49 publications

(18 citation statements)

References 36 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: 36%

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: 36%

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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“…Among them, analyzing only the studies that included a large number of patients, the mean risk of PCa development among patients with HG–PIN was 24.1% (range: 21.7% to 28.9%) [31–33]. In more recent studies, the estimated risk is currently estimated at 18.1% (range: 16.7% to 19.6%) [34, 35, 36]. In the analyzed study, a repeat biopsy was performed in 19 patients with ASAP, and in four of them (21.05%) PCa was diagnosed.…”

Section: Discussionmentioning

confidence: 99%

Significance of atypical small acinar proliferation and extensive high-grade prostatic interaepithelial neoplasm in clinical practice

Adamczyk

Wolski

Butkiewicz

et al. 2014

CEJU

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IntroductionProstate cancer (PCa) is one of the most commonly diagnosed neoplasms in elderly men. The precancerous lesion of PCa is considered a high-grade prostate intraepithelial neoplasm (HG-PIN), while atypical small acinar proliferation (ASAP) is commonly considered as an under-diagnosed cancer. The aim of the study was to establish the impact of ASAP and extensive HG-PIN on pre-biopsy prostate-specific antigen (PSA) levels and the risk of cancer development in subsequent biopseis.Material and methodsThe 1,010 men suspected for PCa were included in the study based on elevated PSA, and/or positive rectal examination. Transrectal ultrasound (TRUS) guided 10 core biopsy was performed. In those with extensive HG-PIN or ASAP on the first biopsy, and/or elevated PSA value, a second biopsy was performed.ResultsIn the second biopsy, PCa was diagnosed in 6 of 19 patients (31.57%) with extensive HG-PIN, in four of 40 (10%) with BPH, and in 4 of 18 (22.22%) with ASAP.There was a statistically significant difference between the values of PSA in the group of patients with ASAP in comparison to those with benign prostate hyperplasia (BPH) (p = 0.005) as well as in patients with HG-PIN in comparison to BPH (p = 0.02).ConclusionsA precancerous lesion diagnosed upon biopsy causes a statistically significant increase in the values of PSA in relation to BPH, as well as in the case of ASAP and extensive HG-PIN.The estimate of risk of PCa diagnosis in patients with ASAP and those with extensive HG-PIN in the first biopsy is comparable, which is why there are no reasons for different treatment of patients with the above-mentioned diagnoses. Both should be subjected to urgent second biopsy in around the 4-6 weeks following the initial biopsy.

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“…The incidence of HGPIN on needle biopsy varies from 0.7 to 25% (Table 1), [3][4][5][6][7][8][9][10][11][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38] with a mean incidence of 9.55% (median 8.75%). Authors from the WHO Consensus Conference in 2000 also reported on the frequency of HGPIN, particularly on needle biopsy specimens, with a range of 0.8-23.9%.…”

Section: Biopsy Seriesmentioning

confidence: 99%

“…1,2 The incidence of HGPIN on contemporary biopsy series ranges up to 20% with most series reporting an incidence of 2.7-9.5%. [3][4][5][6][7][8][9] Given the increasing number of prostate biopsies performed annually in the United States, the number of men with isolated HGPIN is increasing. To date, there is general disagreement about how to properly follow and treat these men.…”

mentioning

confidence: 99%

Contemporary clinical management of isolated high-grade prostatic intraepithelial neoplasia

Godoy

Taneja

2007

Prostate Cancer Prostatic Dis

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High-grade prostatic intraepithelial neoplasia (HGPIN) is a premalignant lesion associated with increased risk of coexistent cancer or delayed progression to carcinoma. Extended biopsy schemes have improved the ability to rule out concurrent cancers, increased the detection of isolated HGPIN and removed the routine necessity for immediate repeat biopsy. As the natural history of HGPIN is poorly defined, and no non-invasive marker allows monitoring of progression to cancer, routine delayed interval biopsy should be considered in all patients. In this article, we present an overview of the existing literature on HGPIN and a proposed strategy for clinical management.

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

Cited by 49 publications

References 36 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

Significance of atypical small acinar proliferation and extensive high-grade prostatic interaepithelial neoplasm in clinical practice

Contemporary clinical management of isolated high-grade prostatic intraepithelial neoplasia

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