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
前列腺癌(prostate cancer,PCa)是男性泌尿生殖系统中最为常见的恶性肿瘤之一,前列腺穿刺是目前诊断PCa的金标准。非典型小腺泡增生(atypical small acinar proliferation,ASAP)在穿刺病理报告中并不少见,表现为疑似癌却又不能确定为癌...前列腺癌(prostate cancer,PCa)是男性泌尿生殖系统中最为常见的恶性肿瘤之一,前列腺穿刺是目前诊断PCa的金标准。非典型小腺泡增生(atypical small acinar proliferation,ASAP)在穿刺病理报告中并不少见,表现为疑似癌却又不能确定为癌的一种病理现象。但目前ASAP对发展为有临床意义的PCa风险作用尚不清楚,对于立即或推迟再次活检缺少共识。本文就ASAP病理学特征、对PCa的预测因素、预测概率和再活检作综述,以指导泌尿外科医生作出最佳决策。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.
文摘前列腺癌(prostate cancer,PCa)是男性泌尿生殖系统中最为常见的恶性肿瘤之一,前列腺穿刺是目前诊断PCa的金标准。非典型小腺泡增生(atypical small acinar proliferation,ASAP)在穿刺病理报告中并不少见,表现为疑似癌却又不能确定为癌的一种病理现象。但目前ASAP对发展为有临床意义的PCa风险作用尚不清楚,对于立即或推迟再次活检缺少共识。本文就ASAP病理学特征、对PCa的预测因素、预测概率和再活检作综述,以指导泌尿外科医生作出最佳决策。
