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• W2050022751 abstract "No AccessJournal of UrologyAdult urology1 Mar 2006Significance of Atypical and Suspicious Small Acinar Proliferations, and High Grade Prostatic Intraepithelial Neoplasia on Prostate Biopsy: Implications for Cancer Detection and Biopsy Strategy Christopher R. Girasole, Michael S. Cookson, Mathew J. Putzi, Sam S. Chang, Joseph A. Smith, Nancy Wells, Jonathan R. Oppenheimer, and Scott B. Shappell Christopher R. GirasoleChristopher R. Girasole More articles by this author , Michael S. CooksonMichael S. Cookson More articles by this author , Mathew J. PutziMathew J. Putzi More articles by this author , Sam S. ChangSam S. Chang More articles by this author , Joseph A. SmithJoseph A. Smith More articles by this author , Nancy WellsNancy Wells More articles by this author , Jonathan R. OppenheimerJonathan R. Oppenheimer More articles by this author , and Scott B. ShappellScott B. Shappell More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)00338-1AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We reviewed our results from a urological pathology reference laboratory with respect to the incidence of HGPIN, and atypical and suspicious lesions in the spectrum of ASAP. Subsequent CaP findings on repeat biopsy with relevant clinical implications were assessed. Materials and Methods: A review of 42,667 prostate biopsies was performed. We defined atypical and suspicious as variants of ASAP with suspicious being more worrisome for CaP. Findings were correlated with the location of CaP on repeat prostate biopsy. Results: The rate of subsequent CaP detection was significantly higher for an initial diagnosis of suspicious findings (51% or 54 of 107 cases) than for atypical findings (34% or 39 of 116) or HGPIN (22% or 79 of 358, p <0.001). CaP was found on the same side of the prostate in 61 of 78 (78%), 30 of 39 (77%) and 41 of 54 patients (76%) with initial HGPIN, atypical and suspicious biopsies, respectively. There was no significant difference among the 3 groups in the likelihood of future CaP at the same site or the same side of the prostate. Conclusions: Patients with a suspicious biopsy were significantly more likely to have CaP on future biopsy than those with atypical findings or HGPIN, suggesting that there may be divisions with prognostic significance in the larger category of ASAP. To our knowledge the reproducibility of recognizing such divisions remains to be established. Neither atypical nor suspicious lesions were more likely than HGPIN to predict CaP at the same site or side of the prostate as the original diagnosis. Repeat biopsy may be indicated in any patient with HGPIN, or atypical or suspicious lesions and this biopsy should not be limited to the site or side of the original pathological findings. References 1 : Pathologic features the urologist should expect on prostate biopsy. Urol Oncol2003; 21: 153. Google Scholar 2 : The focus of “atypical glands, suspicious for malignancy” in prostatic needle biopsy specimens: incidence, histologic features, and clinical follow-up of cases diagnosed in a community practice. Am J Clin Pathol1997; 108: 633. Google Scholar 3 : Strategy for repeat biopsy of patients with prostatic intraepithelial neoplasia detected by prostate needle biopsy. J Urol1996; 155: 228. Link, Google Scholar 4 : Repeat biopsy strategy in patients with atypical small acinar proliferation of high grade prostatic intraepithelial neoplasia on initial prostate needle biopsy. J Urol2001; 166: 866. Link, Google Scholar 5 : Repeat biopsy strategy in men with isolated prostatic intraepithelial neoplasia on prostate needle biopsy. J Urol1996; 156: 460. Link, Google Scholar 6 : Atypical small acinar proliferation suspicious for malignancy in prostate needle biopsies: clinical significance in 33 cases. Am J Surg Pathol1997; 21: 1489. Google Scholar 7 : Diagnosis of “suspicious for malignancy” in prostate biopsies: predictive value for cancer. Urology1998; 51: 749. Google Scholar 8 : Repeat biopsy strategies for men with atypical diagnoses on initial prostate needle biopsy. Urology1998; 52: 803. Google Scholar 9 : Is repeat prostate biopsy for high-grade prostatic intraepithelial neoplasia necessary after routine 12-core sampling?. Urology2001; 58: 999. Google Scholar 10 : 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 Urol2002; 168: 1415. Link, Google Scholar 11 : Predictors of cancer in repeat extended multisite prostate biopsy in men with previous negative extended multisite biopsy. Urology2002; 60: 836. Google Scholar 12 : Monofocal and plurifocal high-grade prostatic intraepithelial neoplasia on extended prostate biopsies: factors predicting cancer detection on extended repeat biopsy. Urology2004; 63: 1105. Google Scholar 13 : Extended peripheral zone biopsy schemes increase cancer detection rates and minimize variance in prostate specific antigen and age related cancer rates: results of a community multi-practice study. J Urol2003; 169: 125. Link, Google Scholar 14 : Prospective evaluation of lateral biopsies of the peripheral zone for prostate cancer detection. J Urol1998; 160: 2111. Link, Google Scholar OUR Lab™ and Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee© 2006 by American Urological AssociationFiguresReferencesRelatedDetails Volume 175Issue 3March 2006Page: 929-933 Advertisement Copyright & Permissions© 2006 by American Urological AssociationKeywordsprostatecarcinomaprostatic intraepithelial neoplasiabiopsyprostatic neoplasmsMetricsAuthor Information Christopher R. Girasole More articles by this author Michael S. Cookson More articles by this author Mathew J. Putzi More articles by this author Sam S. Chang More articles by this author Joseph A. Smith More articles by this author Nancy Wells More articles by this author Jonathan R. Oppenheimer More articles by this author Scott B. Shappell More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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• W2050022751 title "Significance of Atypical and Suspicious Small Acinar Proliferations, and High Grade Prostatic Intraepithelial Neoplasia on Prostate Biopsy: Implications for Cancer Detection and Biopsy Strategy" @default.
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