What is the fate of repeat biopsies after diagnosis of high grade prostatic intraepithelial neoplasia and atypical small acinar proliferation?

Authors : Yakup BOSTANCI, Ender OZDEN, Yarkin YAKUPOĞLU, Serdar SAVASCI, Ali Yilmaz, Saban SARIKAYA

Pages : 241-245

Doi:10.5835/jecm.omu.30.03.007

View : 40 | Download : 7

Publication Date : 2013-11-05

Article Type : Research Paper

Abstract :In this study, we reviewed the outcomes of patients undergoing repeat biopsies, following initial diagnosis of high grade prostatic intraepithelial neoplasia insert ignore into journalissuearticles values(HGPIN); or atypical small acinar proliferation insert ignore into journalissuearticles values(ASAP); and compared the pathological results to second biopsies due to increased PSA. We retrospectively assessed transrectal ultrasound guided prostate biopsy insert ignore into journalissuearticles values(TRUSBP); database at our institution between January 2003 and March 2011. Nonparametric tests and binary logistic regression analysis was performed. Among the 1451 TRUSBP taken, 30.4%, 6.4%, 4.7% were diagnosed as prostate carcinoma insert ignore into journalissuearticles values(PCa);, HGPIN, ASAP, respectively. Among patients with HGPIN and ASAP, 68 patients and 48 patients with subsequent biopsies were selected. We also selected 128 patients with diagnosis of benign prostatic tissue insert ignore into journalissuearticles values(BPT); and subsequent biopsies due to increased PSA. After second biopsy, HGPIN and PCa reported in 29.4% and 20.6%, respectively in HGPIN group; ASAP and PCa was reported in 25% and 37.5%, respectively in ASAP group. Significant increase in PCa rate was reported on second biopsy in ASAP group when compares to HGPIN group insert ignore into journalissuearticles values(37.5% vs 20.6%, p=0.04); and BPT group insert ignore into journalissuearticles values(37.5% vs 18.8%, p=0.009);. Overall, PCa was diagnosed in 26.5%, 45.8%, 18.8% in HGPIN, ASAP, BPT groups, respectively. Significant difference in PCa rate was detected only in ASAP group. PSAD has significant effects on PCa in all groups insert ignore into journalissuearticles values(p=0.001 and p=0.01, respectively);. HGPIN is no longer associated with higher risk of cancer. Patients should be followed with yearly prostate specific antigen insert ignore into journalissuearticles values(PSA); and digital rectal examination insert ignore into journalissuearticles values(DRE);. Repeat biopsy should be made as soon as feasible in patients with ASAP.
Keywords : Atypical small acinar proliferation, biopsy, Prostate carcinoma, Prostatic intraepithelial neoplasia, Prostate specific antigen

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