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Oh, Kim, Yang, Lee, Kim, Jung, and Shim: Prostate Cancer Detection Rate of Rebiopsy in Patients with an Initial Diagnosis of Atypical Small Acinar Proliferation of the Prostate
Original Article

Korean J Urol 2009;50(3):237-240.

Published online: 19 March 2009

DOI: https://doi.org/10.4111/kju.2009.50.3.237

Prostate Cancer Detection Rate of Rebiopsy in Patients with an Initial Diagnosis of Atypical Small Acinar Proliferation of the Prostate

Jung Woo Oh, Yun Beom Kim, Seung Ok Yang, Jeong Ki Lee, Yoon Jung Kim1, Tae Young Jung, Hong Bang Shim

From the Departments of Urology, Seoul Veterans Hospital, Seoul, Korea

1Departments of Pathology, Seoul Veterans Hospital, Seoul, Korea

Correspondence to: Tae Young Jung Department of Urology, Seoul Veterans Hospital, Dunchon 2-dong, Gangdong-gu, Seoul 134-791, Korea TEL: 02-2225-1739 FAX: 02-484-4604 E-mail: urodoct@hotmail.com

Received 17 December 2008       Accepted 16 February 2009

Copyright © 2009 The Korean Urological Association

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

Atypical small acinar proliferation (ASAP) denotes the presence of suspicious glands with insufficient cytological architecture for a definitive prostate cancer diagnosis. We evaluated the subsequent prostate cancer detection rate of rebiopsy in patients with an initial diagnosis of ASAP.

Materials and Methods

Between January 2003 and December 2006, 1,416 men with suspected prostate cancer underwent a transrectal ultrasound-guided prostate biopsy, and 214 (15.1%) were diagnosed as having ASAP. Ninety-five of the 215 patients underwent at least one more biopsy. We evaluated the cancer detection rates after rebiopsy.

Results

In men with ASAP, 36 patients (37.9%) had prostate cancer. The cancer detection rates of the 1st, 2nd, and 3rd rebiopsies were 30.5%, 23.8%, and 40%, respectively. Mean patient age and prostate-specific antigen did not differ significantly between the prostate cancer and noncancer groups after rebiopsy. Prostate volume, however, was significantly smaller in the cancer group (p＜0.05).

Conclusions

Our results showed a detection rate for prostate cancer of 37.9% after an initial diagnosis of ASAP, which indicates that an initial diagnosis of ASAP mandates rebiopsy.

Keywords: Atypical small acinar proliferation, Biopsy, Prostatic neoplasms

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Table 1.
Characteristics of the patients
Total ASAP(rebiopsy)
No. of patients 1416 95
Mean age (years) 70.3 (48-90) 69.4 (57-77)
Median PSA (ng/ml) 18.7 (0.047-3479) 12.7 (2.9-89.9)
Median prostate volume (cc) 43.1 (10.9-154.2) 47.1 (12.6-141.9)

PSA: prostate-specific antigen, ASAP: atypical small acinar pro-iferation

Table 2.
Results of rebiopsy
Rebiopsy No. of patients Rebiopsy diagnosis
Negative ASAP Cancer
1st 95 39 27 29 (30.5%)
2nd 21 9 7 5 (23.8%)
3rd 5 2 1 2 (40.0%)

ASAP: atypical small acinar proliferation

Table 3.
Median parameters in patients after rebiopsy
Total (n=95) Cancer (n=36) No cancer (n=59) p-valuea
Age (years) 69.4 68.9 69.7 0.404
PSA (ng/ml) 12.7 13.3 12.3 0.731
Prostate volume (cc) 41.7 38.5 53.1 0.003

PSA: prostate-specific antigen.

a p-value: Student’s t-test

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