Objective: Establish the prostate cancer (PCa) detection rate and the premalignant lesion incidence, as well as their importance in cancer detection at the first rebiopsy.
Materials And Methods: In the period 2006-2008, at the CCUS Urology Clinic, there were 585 prostate biopsies performed in 515 patients. 12% of the patients underwent the first biopsy due to premalignant lesion findings. The main characteristics of the patients--age, prostate specific antigen (PSAt)-total and PSA ratio (PSAr), the number of needle biopsies, Gleason score and the role of premalignant lesions in diagnosis of PCa at the first rebiopsy were processed retrospectively.
Results: Primarily detected PCa amounted to 32.4% (167/515), while the rebiopsy showed the detection rate of 35.7% (25/70). No statistically significant age or PSAt and PSAr difference was observed, while there was, however, a difference in the number of biopsy samples, 11 (6-18) vs. 12 (8-20) and in the Gleason score (6.5 vs. 5.9) among the observed groups (p < 0.05). Atypical small acinar proliferation (ASAP) and high grade intra epithelial neoplasia (HGPIN), were found in 4.95% and 7.2% of the cases, while the ASAP + HGPIN combination was found in 1.5% of the cases. The PCa detection rate at the first rebiopsy in patients with ASAP, HGPIN and ASAP + HGPIN lesions was 50%, 23.6% and 50%, respectively. The ANOVA test showed a statistically significant shorter time period for rebiopsy in ASAP+HGPIN patients than that of patients with ASAP and HGPIN lesions.
Conclusion: A repeated positive biopsy establishes PCa in patients with lower PSAt values and the Gleason score, which is followed by an increased number of biopsy samples. ASAP and ASAP + HGPIN lesions carry a higher specificity of75% and 91%, respectively, while the PPV in prostate cancer detection for HGPIN is low (24%).
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Article Synopsis
- The study aimed to analyze the prevalence of atypical small acinar proliferation (ASAP) and high-grade prostatic intraepithelial neoplasia (HGPIN) in prostate biopsies in China, and the subsequent risk of prostate cancer (PCa) in follow-up biopsies.
- Among 2,456 patients, initial biopsies showed a considerable rate of PCa (30%), with lower rates for ASAP (8.8%) and HGPIN (4%). Patients with ASAP were more likely to be diagnosed with PCa in subsequent biopsies as compared to those with HGPIN.
- The results suggest that ASAP is a strong indicator for the need for
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