Different clinical significance of ASAP/HGPIN pattern in systematic vs. MRI‑US fusion guided prostate biopsy

Andras,Iulia; Telecan,Teodora; Crisan,Dana; Cata,Emanuel; Kadula,Pierre; Andras,David; Bungardean,Maria; Coman,Ioan; Crisan,Nicolae

doi:10.3892/etm.2020.9325

December-2020 Volume 20 Issue 6

Full Size Image

Journals

International Journal of Molecular Medicine

International Journal of Molecular Medicine is an international journal devoted to molecular mechanisms of human disease.

International Journal of Oncology

International Journal of Oncology is an international journal devoted to oncology research and cancer treatment.

Molecular Medicine Reports

Covers molecular medicine topics such as pharmacology, pathology, genetics, neuroscience, infectious diseases, molecular cardiology, and molecular surgery.

Oncology Reports

Oncology Reports is an international journal devoted to fundamental and applied research in Oncology.

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine is an international journal devoted to laboratory and clinical medicine.

Oncology Letters

Oncology Letters is an international journal devoted to Experimental and Clinical Oncology.

Biomedical Reports

Explores a wide range of biological and medical fields, including pharmacology, genetics, microbiology, neuroscience, and molecular cardiology.

Molecular and Clinical Oncology

International journal addressing all aspects of oncology research, from tumorigenesis and oncogenes to chemotherapy and metastasis.

World Academy of Sciences Journal

Multidisciplinary open-access journal spanning biochemistry, genetics, neuroscience, environmental health, and synthetic biology.

International Journal of Functional Nutrition

Open-access journal combining biochemistry, pharmacology, immunology, and genetics to advance health through functional nutrition.

International Journal of Epigenetics

Publishes open-access research on using epigenetics to advance understanding and treatment of human disease.

Medicine International

An International Open Access Journal Devoted to General Medicine.

December-2020 Volume 20 Issue 6

Full Size Image

Article

Different clinical significance of ASAP/HGPIN pattern in systematic vs. MRI‑US fusion guided prostate biopsy

Authors:
- Iulia Andras
- Teodora Telecan
- Dana Crisan
- Emanuel Cata
- Pierre Kadula
- David Andras
- Maria Bungardean
- Ioan Coman
- Nicolae Crisan
View Affiliations / Copyright

Affiliations: Urology Department, ‘Iuliu Hatieganu’ University of Medicine and Pharmacy, 400012 Cluj‑Napoca, Romania, Internal Medicine Department, 5th Medical Clinic, ‘Iuliu Hatieganu’ University of Medicine and Pharmacy, 400012 Cluj‑Napoca, Romania, Urology Department, Clinical Municipal Hospital, 400139 Cluj‑Napoca, Romania, General Surgery Department, ‘Iuliu Hatieganu’ University of Medicine and Pharmacy, 400012 Cluj‑Napoca, Romania, Pathology Department, Emergency County Hospital, 400006 Cluj‑Napoca, Romania
Article Number: 195
|
Published online on: October 14, 2020

https://doi.org/10.3892/etm.2020.9325
Expand metrics +

Abstract

Atypical small acinar proliferation (ASAP) and high grade intraepithelial neoplasia (HGPIN) patterns identified at prostate biopsy yield an important clinical significance, their presence signaling an increased likelihood of future oncological development or underdiagnosed PCa. MRI and MRI‑TRUS fusion prostate biopsy have recently become the standard for the diagnosis of prostate cancer. Thus, we aimed to assess the role of ASAP/HGPIN pattern in the context of these recent developments as compared with the standard systematic biopsy. The present study included 400 patients who underwent MRI‑TRUS fusion prostate biopsy. A subgroup of these patients had a history of prior systematic biopsy and their results were also included in the analysis. We observed that ASAP/HGPIN pattern diagnosed at systematic biopsy is suggestive of a high‑volume clinically‑significant disease, most probably located outside the standard sampling area. On the contrary, ASAP/HGPIN at MRI‑TRUS fusion biopsy has clinical features more similar to benign prostate hyperplasia, thus suggesting a more incipient disease, if present. No relation between concurrent ASAP/HGPIN and PCa was observed in our study.

View Figures

View References

1	Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA and Jemal A: Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 68:394–424. 2018.PubMed/NCBI View Article : Google Scholar
2	Eastham J: Prostate cancer screening. Investig Clin Urol. 58:217–219. 2017.PubMed/NCBI View Article : Google Scholar
3	Chrisofos M, Papatsoris AG, Lazaris A and Deliveliotis C: Precursor lesions of prostate cancer. Crit Rev Clin Lab Sci. 44:243–270. 2007.PubMed/NCBI View Article : Google Scholar
4	De Marzo AM, Haffner MC, Lotan TL, Yegnasubramanian S and Nelson WG: Premalignancy in prostate cancer: Rethinking what we know. Cancer Prev Res (Phila). 9:648–656. 2016.PubMed/NCBI View Article : Google Scholar
5	Montironi R, Mazzucchelli R, Lopez-Beltran A, Scarpelli M and Cheng L: Prostatic intraepithelial neoplasia: Its morphological and molecular diagnosis and clinical significance. BJU Int. 108:1394–1401. 2011.PubMed/NCBI View Article : Google Scholar
6	Leite KR, Mitteldorf CA and Camara-Lopes LH: Repeat prostate biopsies following diagnoses of prostate intraepithelial neoplasia and atypical small gland proliferation. Int Braz J Urol. 31:131–136. 2005.PubMed/NCBI View Article : Google Scholar
7	Bostwick DG and Qian J: High-grade prostatic intraepithelial neoplasia. Mod Pathol. 17:360–379. 2004.PubMed/NCBI View Article : Google Scholar
8	Epstein JI and Herawi M: Prostate needle biopsies containing prostatic intraepithelial neoplasia or atypical foci suspicious for carcinoma: Implications for patient care. J Urol. 175:820–834. 2006.PubMed/NCBI View Article : Google Scholar
9	Adamczyk P, Wolski Z, Butkiewicz R, Nussbeutel J and Drewa T: Significance of atypical small acinar proliferation and extensive high-grade prostatic intraepithelial neoplasm in clinical practice. Cent European J Urol. 67:136–141. 2014.PubMed/NCBI View Article : Google Scholar
10	Heidenreich A, Bastian PJ, Bellmunt J, Bolla M, Joniau S, van der Kwast T, Mason M, Matveev V, Wiegel T, Zattoni F, et al: European Association of Urology: EAU guidelines on prostate cancer. Part 1: Screening, diagnosis, and local treatment with curative intent-update 2013. Eur Urol. 65:124–137. 2014.PubMed/NCBI View Article : Google Scholar
11	Warlick C, Feia K, Tomasini J, Iwamoto C, Lindgren B and Risk M: Rate of Gleason 7 or higher prostate cancer on repeat biopsy after a diagnosis of atypical small acinar proliferation. Prostate Cancer Prostatic Dis. 18:255–259. 2015.PubMed/NCBI View Article : Google Scholar
12	Crisan N, Andras I, Radu C, Andras D, Coman RT, Tucan P, Pisla D, Crisan D and Coman I: Prostate ultrasound: Back in business! Med. Ultrason. 19:423–429. 2017.PubMed/NCBI View Article : Google Scholar
13	Ahmed HU, El-Shater Bosaily A, Brown LC, Gabe R, Kaplan R, Parmar MK, Collaco-Moraes Y, Ward K, Hindley RG, Freeman A, et al: Diagnostic accuracy of multi-parametric MRI and TRUS biopsy in prostate cancer (PROMIS): A paired validating confirmatory study. Lancet. 389:815–822. 2017.PubMed/NCBI View Article : Google Scholar
14	Kasivisvanathan V, Rannikko AS, Borghi M, Panebianco V, Mynderse LA, Vaarala MH, Briganti A, Budäus L, Hellawell G, Hindley RG, et al: MRI-targeted or standard biopsy for prostate-cancer diagnosis. N Engl J Med. 378:1767–1777. 2018.PubMed/NCBI View Article : Google Scholar
15	Ryu JH, Kim YB, Lee JK, Kim YJ and Jung TY: Predictive factors of prostate cancer at repeat biopsy in patients with an initial diagnosis of atypical small acinar proliferation of the prostate. Korean J Urol. 51:752–756. 2010.PubMed/NCBI View Article : Google Scholar
16	Pepe P, Garufi A, Priolo G and Pennisi M: Transperineal versus transrectal MRI/TRUS Fusion targeted biopsy: Detection rate of clinically significant prostate cancer. Clin Genitourin Cancer. 15:e33–e36. 2017.PubMed/NCBI View Article : Google Scholar
17	Winther MD, Balslev I, Boesen L, Logager V, Noergaard N, Thestrup KD and Thomsen HS: Magnetic resonance imaging- guided biopsies may improve diagnosis in biopsy-naive men with suspicion of prostate cancer. Dan Med J. 64(A5355)2017.PubMed/NCBI
18	Liddell H, Jyoti R and Haxhimolla HZ: mp-MRI prostate characterised PIRADS 3 lesions are associated with a low risk of clinically significant prostate cancer - a retrospective review of 92 biopsied PIRADS 3 lesions. Curr Urol. 8:96–100. 2015.PubMed/NCBI View Article : Google Scholar
19	Eminaga O, Hinkelammert R, Abbas M, Titze U, Eltze E, Bettendorf O and Semjonow A: High-grade prostatic intraepithelial neoplasia (HGPIN) and topographical distribution in 1,374 prostatectomy specimens: Existence of HGPIN near prostate cancer. Prostate. 73:1115–1122. 2013.PubMed/NCBI View Article : Google Scholar

Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Different clinical significance of ASAP/HGPIN pattern in systematic vs. MRI‑US fusion guided prostate biopsy

This article is mentioned in:

Abstract

Related Articles