Natural history of widespread high grade prostatic intraepithelial neoplasia and atypical small acinar proliferation: should we rebiopsy them all?

Autor:	Marco Agnello, Luisa Delsedime, Paolo Gontero, Donatella Pacchioni, Andrea Giordano, M. Barale, Riccardo Faletti, Alessandro Marquis, Claudia Filippini, Marco Falcone, Giorgio Calleris, Marco Oderda, Lorenzo Daniele, Matteo Rosazza, Giancarlo Marra
Rok vydání:	2021
Předmět:	Male Reoperation Pathology medicine.medical_specialty Prostate biopsy Urology Biopsy ASAP HGPIN prostate biopsy prostate cancer widespread 030232 urology & nephrology 030204 cardiovascular system & hematology 03 medical and health sciences Prostate cancer 0302 clinical medicine medicine Humans High-grade prostatic intraepithelial neoplasia Aged Cell Proliferation Retrospective Studies Prostatic Intraepithelial Neoplasia Intraepithelial neoplasia Atypical small acinar proliferation medicine.diagnostic_test business.industry Prostatic Neoplasms Middle Aged medicine.disease Natural history Nephrology Disease Progression business
Zdroj:	Scandinavian journal of urology. 55(2)
ISSN:	2168-1813
Popis:	To evaluate the premalignant potential of high-grade prostatic intraepithelial neoplasia (HGPIN) and atypical small acinar proliferation (ASAP).Patients diagnosed with monofocal HGPIN (mHGPIN), widespread HGPIN (≥4 cores, wHGPIN) and/or ASAP who underwent at least one rebiopsy during their follow-up, were enrolled. All enrollment biopsies underwent central pathologic revision. Risks for PCa were estimated using Fine and Gray method for competing risk.Pathologic revision changed the original diagnosis in 32.3% of cases. Among 336 cases enrolled, PCa was diagnosed in 164 (48.8%), and more specifically in 20 (30.3%) mHGPIN, 10 (34.5%) wHGPIN, 101 (54.0%) ASAP, and 33 (61.1%) HGPIN + ASAP (mean follow-up 124 months). Most PCa were Gleason score 6(3 + 3) (51.0%) and 7(3 + 4) (34.3%). On multivariate analysis, HGPIN + ASAP (HR 2.76,The diagnosis of ASAP and HGPIN strongly relies on the expertise of dedicated uro-pathologists. Finding of ASAP is a strong risk factor for a subsequent PCa diagnosis, advising a rebiopsy, possibly within 3 months. m/wHGPIN should not be routinely rebiopsied.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::826badd69bd95e8861f9b350b41da81c https://pubmed.ncbi.nlm.nih.gov/33410348 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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