Atypical small acinar proliferation is a histopathological diagnosis of unspecified importance in prostate needle-biopsy reports,suggestive but not definitive for cancer.The terminology corresponds to some uncertainty...Atypical small acinar proliferation is a histopathological diagnosis of unspecified importance in prostate needle-biopsy reports,suggestive but not definitive for cancer.The terminology corresponds to some uncertainty in the biopsy report,as the finding might represent an underlying non-cancerous pathology mimicking cancer or an under-sampled prostate cancer site.Therefore,traditional practice favors an immediate repeat biopsy.However,in modern urological times,the need of urgent repeat biopsy is being challenged by some authors as in the majority of cases,the grade of cancer found in subsequent biopsy is reported to be low or the disease to be non-significant.On the other hand,high risk disease cannot be excluded,whereas no clinical or pathological factors can predict the final outcome.In this review,we discuss the significance of the diagnosis of atypical small acinar proliferation in the biopsy report,commenting on its importance in modern urological practice.展开更多
Introduction:The histological diagnosis of prostate cancer is commonly based on morphological patterns.The presence of malignant tissue mixed with benign tissue,or the presence of carcinoma that mimics benignity may g...Introduction:The histological diagnosis of prostate cancer is commonly based on morphological patterns.The presence of malignant tissue mixed with benign tissue,or the presence of carcinoma that mimics benignity may generate difficulty in the diagnostic elucidation.Therefore,the application of immunohistochemistry contributes its diagnostic value.Objectives:To evaluate the 34βE12 marker in the detection of adenocarcinoma(ADn),atypical small acinar proliferation(ASAp),regular prostatic tissue(RPT)and regular prostatic tissue alternated by atrophy spotlights(RPTa)in transrectal biopsy guided by ultrasonography of patients with suspected prostate cancer.Method:Analysis of 34 patients who underwent ultrasound-guided transrectal biopsy with subsequent analysis by H&E staining and 34βE12 labeling for elucidation of neoplasms or diseased tissues with doubtful diagnosis.Results:The marker 34βE12 showed negativity in 100%of the neoplasms ADn,positivity in 100%of the benign prostatic tissues(RPT and RPTa);the patients with ASAp presented positivity(20%)and negativity(80%).The chi-square test(χ2)showed that there is an association(χ2=29.55 and p<0.0001)between the groups,that is,the 34βE12 marker has a significant value(p<0.0001)in the elucidation of patients with prostatic neoplasia and benign prostatic tissues.Discussion and Conclusion:With the early screening of prostate cancer in the modern era,pathologists have become increasingly challenged to diagnose small outbreaks of cancer when only a few atypical glands are present in transrectal biopsy-guided ultrasonography.The 34βE12 marker becomes an important tool in elucidating diagnoses such as ADn and ASAp.展开更多
The current literature does not support the usefulness of clinical markers on predicting which patients with atypical small acinar proliferation （ASAP） are more likely to progress to prostate cancer （PCa）. Androge...The current literature does not support the usefulness of clinical markers on predicting which patients with atypical small acinar proliferation （ASAP） are more likely to progress to prostate cancer （PCa）. Androgens have long been considered to be the potential risk factors for PCa. However, the role of testosterone is controversial. The present study aims to analyze the relationship between serum testosterone （TS） levels and the diagnosis of PCa after a first prostate biopsy in patients affected by ASAP. This retrospective study included 143 patients diagnosed with ASAP in an initial transrectal ultrasound-guided prostate biopsy for suspicious PCa according to the European Association of Urology guidelines. Their TS levels, age, PSA, prostate volume, digital rectal examination, and prostate biopsy Gleason score （GS） were collected retrospectively for statistical analysis. All patients included in the study had a second biopsy and were suitable for further analysis. Re-biopsy was carried out 3-6 months after the first diagnosis of ASAP. Low and normal TS groups were composed of 29 （20.3%） and 114 （79.7%） patients, respectively. The diagnosis of the second biopsy was ASAP in 25.2% and PCa in 36.4% of patients. The comparison between patients with PCa and those with negative or an ASAP result in the second biopsy reported that men with cancer had significantly higher levels of TS （P 〈 0.001）. However, there was no statistically significant association between GS postbiopsy and TS （P = 0.324）. Our experience demonstrated that eugonadal patients may be a clinical risk factor for the diagnosis of PCa on re-biopsy after ASAP diagnosis than hypogonadal.展开更多
Background: In the diagnosis of prostatic diseases, the need for markers other than prostate specific antigen (PSA) has been increasing in recent years. So, we aimed to determine the predictive value, the neutrophil l...Background: In the diagnosis of prostatic diseases, the need for markers other than prostate specific antigen (PSA) has been increasing in recent years. So, we aimed to determine the predictive value, the neutrophil lymphocyte ratio, platelet-to-lymphocyte ratio and mean platelet volume before prostate biopsy in predicting the results of pathology. Transrectal ultrasound-guided biopsy of the prostate was performed because of high PSA values and compared values of these parameters to predict of pathology results. Methods: 2715 patients who underwent 10 - 12 quadrant transrectal ultrasound-guided prostate biopsies between January 2008 and January 2018 have been evaluated retrospectively. Patients were divided into groups according to the biopsy pathology results by benign (group 1), atypical small acinar proliferation (ASAP) (group 2) and prostate cancer (group 3). A total of 204 patients who were benign prostate hyperplasia in 71 patients (34.8%), atypical small acinar proliferation in 80 (39.21%) and prostate adenocarcinoma (PCa) in 53 patients (25.98%) were included in the study by systematic sampling. Before the biopsy total PSA (tPSA), free PSA (fPSA), rate of percentage of free to total prostate specific antigen (f/tPSA) rate, PSA density (PSA-D), white blood cell (WBC) count, blood neutrophil count (NC), blood lymphocyte count (LC), neutrophil lymphocyte ratio (NLR), mean platelet volume (MPV), platelet count (PLT) and platelet-to-lymphocyte ratio (PLR) were measured and compared in all groups. Differences in continuous variables were assessed using the ANOVA. Logistic regression was used to analyze the linear relationship between predictive variables and pathology results. P < 0.05 was considered statistically significant. Results: NLR and PLR values were lower in group 1 than group 2 and were found statistically significant between in group 1 and group 2 (p: 0.03 and p: 0.02, respectively). MPV value was found 1.7 times higher in patients who were diagnosed with ASAP pathology than those with benign pathol展开更多
文摘Atypical small acinar proliferation is a histopathological diagnosis of unspecified importance in prostate needle-biopsy reports,suggestive but not definitive for cancer.The terminology corresponds to some uncertainty in the biopsy report,as the finding might represent an underlying non-cancerous pathology mimicking cancer or an under-sampled prostate cancer site.Therefore,traditional practice favors an immediate repeat biopsy.However,in modern urological times,the need of urgent repeat biopsy is being challenged by some authors as in the majority of cases,the grade of cancer found in subsequent biopsy is reported to be low or the disease to be non-significant.On the other hand,high risk disease cannot be excluded,whereas no clinical or pathological factors can predict the final outcome.In this review,we discuss the significance of the diagnosis of atypical small acinar proliferation in the biopsy report,commenting on its importance in modern urological practice.
文摘Introduction:The histological diagnosis of prostate cancer is commonly based on morphological patterns.The presence of malignant tissue mixed with benign tissue,or the presence of carcinoma that mimics benignity may generate difficulty in the diagnostic elucidation.Therefore,the application of immunohistochemistry contributes its diagnostic value.Objectives:To evaluate the 34βE12 marker in the detection of adenocarcinoma(ADn),atypical small acinar proliferation(ASAp),regular prostatic tissue(RPT)and regular prostatic tissue alternated by atrophy spotlights(RPTa)in transrectal biopsy guided by ultrasonography of patients with suspected prostate cancer.Method:Analysis of 34 patients who underwent ultrasound-guided transrectal biopsy with subsequent analysis by H&E staining and 34βE12 labeling for elucidation of neoplasms or diseased tissues with doubtful diagnosis.Results:The marker 34βE12 showed negativity in 100%of the neoplasms ADn,positivity in 100%of the benign prostatic tissues(RPT and RPTa);the patients with ASAp presented positivity(20%)and negativity(80%).The chi-square test(χ2)showed that there is an association(χ2=29.55 and p<0.0001)between the groups,that is,the 34βE12 marker has a significant value(p<0.0001)in the elucidation of patients with prostatic neoplasia and benign prostatic tissues.Discussion and Conclusion:With the early screening of prostate cancer in the modern era,pathologists have become increasingly challenged to diagnose small outbreaks of cancer when only a few atypical glands are present in transrectal biopsy-guided ultrasonography.The 34βE12 marker becomes an important tool in elucidating diagnoses such as ADn and ASAp.
文摘The current literature does not support the usefulness of clinical markers on predicting which patients with atypical small acinar proliferation （ASAP） are more likely to progress to prostate cancer （PCa）. Androgens have long been considered to be the potential risk factors for PCa. However, the role of testosterone is controversial. The present study aims to analyze the relationship between serum testosterone （TS） levels and the diagnosis of PCa after a first prostate biopsy in patients affected by ASAP. This retrospective study included 143 patients diagnosed with ASAP in an initial transrectal ultrasound-guided prostate biopsy for suspicious PCa according to the European Association of Urology guidelines. Their TS levels, age, PSA, prostate volume, digital rectal examination, and prostate biopsy Gleason score （GS） were collected retrospectively for statistical analysis. All patients included in the study had a second biopsy and were suitable for further analysis. Re-biopsy was carried out 3-6 months after the first diagnosis of ASAP. Low and normal TS groups were composed of 29 （20.3%） and 114 （79.7%） patients, respectively. The diagnosis of the second biopsy was ASAP in 25.2% and PCa in 36.4% of patients. The comparison between patients with PCa and those with negative or an ASAP result in the second biopsy reported that men with cancer had significantly higher levels of TS （P 〈 0.001）. However, there was no statistically significant association between GS postbiopsy and TS （P = 0.324）. Our experience demonstrated that eugonadal patients may be a clinical risk factor for the diagnosis of PCa on re-biopsy after ASAP diagnosis than hypogonadal.
文摘Background: In the diagnosis of prostatic diseases, the need for markers other than prostate specific antigen (PSA) has been increasing in recent years. So, we aimed to determine the predictive value, the neutrophil lymphocyte ratio, platelet-to-lymphocyte ratio and mean platelet volume before prostate biopsy in predicting the results of pathology. Transrectal ultrasound-guided biopsy of the prostate was performed because of high PSA values and compared values of these parameters to predict of pathology results. Methods: 2715 patients who underwent 10 - 12 quadrant transrectal ultrasound-guided prostate biopsies between January 2008 and January 2018 have been evaluated retrospectively. Patients were divided into groups according to the biopsy pathology results by benign (group 1), atypical small acinar proliferation (ASAP) (group 2) and prostate cancer (group 3). A total of 204 patients who were benign prostate hyperplasia in 71 patients (34.8%), atypical small acinar proliferation in 80 (39.21%) and prostate adenocarcinoma (PCa) in 53 patients (25.98%) were included in the study by systematic sampling. Before the biopsy total PSA (tPSA), free PSA (fPSA), rate of percentage of free to total prostate specific antigen (f/tPSA) rate, PSA density (PSA-D), white blood cell (WBC) count, blood neutrophil count (NC), blood lymphocyte count (LC), neutrophil lymphocyte ratio (NLR), mean platelet volume (MPV), platelet count (PLT) and platelet-to-lymphocyte ratio (PLR) were measured and compared in all groups. Differences in continuous variables were assessed using the ANOVA. Logistic regression was used to analyze the linear relationship between predictive variables and pathology results. P < 0.05 was considered statistically significant. Results: NLR and PLR values were lower in group 1 than group 2 and were found statistically significant between in group 1 and group 2 (p: 0.03 and p: 0.02, respectively). MPV value was found 1.7 times higher in patients who were diagnosed with ASAP pathology than those with benign pathol
