Prostate cancer detection following diagnosis of atypical small acinar proliferation.
Prostate cancer detection following diagnosis of atypical small acinar proliferation.
复制标题
诊断非典型小腺泡增殖后前列腺癌的检测。
DOI：
--
复制
发表时间：
2017
期刊：
影响因子：
--
通讯作者：
S. Eggener
中科院分区：
文献类型：
--
作者：
Kyle J. Ericson;H. Wenger;A. Rosen;Kyle J. Kiriluk;G. Gerber;G. Paner;S. Eggener
引言
报告诊断为不典型小腺泡细胞增生症(ASAP)后癌症的发生率和特征，并对当前的临床实践建议进行评论。
材料和方法
我们回顾了2008至2013年间在一家机构接受前列腺活检的患者。早期无癌症史的男性也包括在内。分析了接受重复前列腺活检的男性患者的临床病理特征，包括前列腺特异性抗原(PSA)、ASAP或癌症的存在、肿瘤体积、受累核心数量和Gleason评分。
结果
在1450名男性中，75名(5%)患者发现了ASAP。49例(65%)患者进行了重复活检。15例(31%)被诊断为癌症，10例(20%)为ASAP，24例(49%)为良性。PSA、年龄和ASAP核心数与癌症无关。12例(80%)诊断为Gleason 6病。在3名患者中发现了格里森≥7癌，占所有重复活检患者的6%。肿瘤平均线形体积3.2 mm，平均肿瘤体积14.2%。
结论
在当代的前列腺活检系列中，ASAP的发生率为5%。在患有ASAP的男性中，重复活检的癌症发生率为31%，绝大多数是低级别和低体积。在适当的临床情况下，ASAP患者可能在6个月内不需要重复活检。
INTRODUCTION
To report the incidence and characteristics of cancer following a diagnosis of atypical small acinar proliferation (ASAP) and comment on current clinical practice recommendations.
MATERIALS AND METHODS
We reviewed patients that underwent prostate biopsy between 2008 and 2013 at a single institution. Men with ASAP without previous cancer were included. Clinicopathologic features including prostate-specific antigen (PSA), presence of ASAP or cancer, tumor volume, number of involved cores, and Gleason score were analyzed in men that received a repeat prostate biopsy.
RESULTS
Of 1450 men, ASAP was found in 75 (5%) patients. Repeat biopsy was performed in 49 (65%) patients. Fifteen (31%) were diagnosed with cancer, 10 (20%) with ASAP, and 24 (49%) were benign. PSA, age, and number of cores with ASAP were not associated with cancer. Gleason 6 disease was diagnosed in 12 (80%) patients. Gleason ≥ 7 cancer was found in 3 patients, or 6% of all patients with a repeat biopsy. The average linear amount of tumor was 3.2 mm, and the average tumor volume was 14.2%.
CONCLUSION
In a contemporary prostate biopsy series, the incidence of ASAP was 5%. Among men with ASAP, incidence of cancer at repeat biopsy was 31%, with the overwhelming majority being low grade and low volume. Patients with ASAP may not require repeat biopsy within 6 months in the appropriate clinical context.