Repeat transrectal prostate biopsy in patients with high grade prostatic intraepithelial neoplasia: optimal time and technique
https://doi.org/10.17650/1726-9776-2008-4-4-30-32
Abstract
Purpose. The aim of our study was to define optimal time and technique of repeat transrectal prostate biopsy in patients with high grade prostatic intraepithelial neoplasia.
Materials and Methods. A total of 277 men with high grade prostatic intraepithelial neoplasia regardless of changes in serum prostate specific antigen (PSA) or digital rectal examination findings underwent follow up biopsy in 8 months (range 1—12 months) after diagnosis. All men had at least 12 (12—18) biopsy cores taken at the time of diagnosis.
Results. Prostate cancer was found in 29,2% cases (81 of 277 patiens) after the second biopsy and in 2,9 % (1 of 35) cases after the third biopsy. The highest detection rate was found using 14 and 16 core biopsy schemes 12 and 6 months after the first biopsy.
Conclusions. Our findings support the concept that high grade prostatic intraepithelial neoplasia is a precursor to prostate cancer and that repeat biopsy at a delayed interval is recommended regardless of changes in PSA.
About the Authors
M. A. Kurdzhiev
Moscow State University of Medicine and Dentistry
Russian Federation
Urology Department
Russian Federation
Urology Department
A. V. Govorov
Moscow State University of Medicine and Dentistry
Russian Federation
Urology Department
Russian Federation
Urology Department
D. Y. Pushkar
Moscow State University of Medicine and Dentistry
Russian Federation
Urology Department
Russian Federation
Urology Department
M. V. Kovylina
Moscow State University of Medicine and Dentistry
Russian Federation
Urology Department
Russian Federation
Urology Department
References
1. Ayala A.G., Naya Y., Tamboli P. et al. High-grade prostatic intraepithelial neoplasia (PIN) and invasive adenocarcinoma: case repot and pre-liminary study of 103 patients with high-grade PIN. Pathol Case Rev 2003;8:61—7.
2. Bishara T., Rammani D.M., Epstein J.I. High-grade prostatic intraepithelial neoplasia on needle biopsy. Am J Surg Pathol 2004;28:629—33.
3. Bostwick D.G. High grade prostatic intraepithelial neoplasia. Mod Pathol 2004;17:360—79.
4. Bostwick D.G. Prostatic Intraepithelial Neoplasia (PIN). Urology 1989;34:16—22.
5. McNeal J.E., Bostwick D.G. Intraductal dysplasia: A premalignant lesion of the prostate. Hum Pathol 1986;17:64—71.
6. Epstein J.I., Grignon D.J., Humphrey P. et al. Interobserver reproducibility in the diagnosis of intraepithelial neoplasia. Am J Surg Pathol 1995;19:873—6.
7. Orozco R., O'Dowd G.J., Kunnel B. et al. Observations on pathology trends in 62,537 prostate biopsies obtained from urology private practices in the United States. Urology 1998;51:186—95.
8. Steiner M.S. High-grade prostatic intraepithelial neoplasia and prostate cancer risk reduction. World J Urol 2003;21:15—20.
9. Davidson D., Bostwick D.G., Qian J. et al. Prostatic intraepithelial neoplasia is a risk factor for adenocarcinoma: predictive accuracy in needle biopsies. J Urol 1995;154:1295—9.
10. Girasole C.R., Cookson M.S., Putzi M.J. et al. Significance of atypical and suspicious small acinar proliferations, and high grade prostatic intraepithelial neoplasia on prostate biopsy: implications for cancer detection and biopsy strategy. J Urol 2006;175(3):929—33.
11. Joniau S., Goeman L., Pennings J., Van Poppel H. Prostatic intraepithelial neoplasia (PIN): importance and clinical management. Eur Urol 2005;48(3):379—85.
12. O`Dowd G.J., Miller G., Orozco R., Veltri R.W. Analysis of repeated biopsy result within 1 year after a noncancer diagnosis. Urology 2000;55(4):553—9.
13. Epstein J.I., Herawi M. Prostate needle biopsies containing prostatic intraepithelial neoplasia or atypical foci suspicious for carcinoma: implications for patient care. J Urol 2006;175(3):820—34.
14. Herawi M., Kahane H., Cavallo C., Epstein J.I. Risk of prostate cancer on first re-biopsy within 1 year following a diagnosis of high grade prostatic intraepithelial neoplasia is related to the number of cores sampled. J Urol 2006;175(1):121—4.
15. Moore C.K., Karikehallis S., Nazeer T. et al. Prognostic significance of high grade prostatic intraepithelial neoplasia and atypical small acinar proliferation in the contemporary era. J Urol 2005;173(1):70—2.
16. Lefkowitz G.K., Taneja S.S., Brown J. et al. Followup interval prostate biopsy 3 years after diagnosis of high grade prostatic intraepithelial neoplasia is associated with high likelihood of prostate cancer, independent of change in prostate specific antigen levels. J Urol 2002;168(4):1415—8.
17. Ковылина М.В. Клиникоморфологическая характеристика предраковых заболеваний и рака предстательной железы. Автореф. дис. … канд. мед. наук. М.; 2006.
18. McNeal J.E., Villers A., Redwine E.A. et al. Microcarcinoma of the prostate: its association with duct-acinar dysplasia. Hum Pathol 1991;22:644.
19. Srodom M., Epstein J.I. Central zone histology of the prostate: a mimicker of high-grade prostatic intraepithelial neoplasia. Hum Pathol 2002;33:518—23.
Review
For citations:
Kurdzhiev M.A., Govorov A.V., Pushkar D.Y., Kovylina M.V. Repeat transrectal prostate biopsy in patients with high grade prostatic intraepithelial neoplasia: optimal time and technique. Cancer Urology. 2008;4(4):30-32. (In Russ.) https://doi.org/10.17650/1726-9776-2008-4-4-30-32
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