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

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
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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
Published online on: October 14, 2020 https://doi.org/10.3892/etm.2020.9325
Article Number: 195

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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.

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