Diagnosis of "suspicious for malignancy" in prostate biopsies: predictive value for cancer

摘要: Abstract Objectives. Prostate needle biopsies occasionally contain an atypical small acinar proliferation (ASAP) that is suspicious for but not diagnostic of malignancy. The predictive value ASAP cancer has been studied in a large series. Methods. To determine the reproducibility and clinical significance urologic reference laboratory, we retrospectively 295 patients with diagnosed from 1991 to 1995. Each patient had at least one follow-up biopsy. Mean age was 68.0 years (range 40 89). Numerous histologic features were assessed their malignancy on subsequent Results. Adenocarcinoma identified biopsy 125 (42%), median 5.7 months 0.1 43). Gleason score varied 4 9 (mean 6.2). Cumulative detection cancers 90% after second 99% third Serum prostate-specific antigen, digital rectal examination result, Likewise, number cores findings including acini per focus ASAP, foci degree nuclear nucleolar enlargement, presence luminal pink granular secretions, mucin, or crystalloids cancer. Stratifying our level suspicion into three categories (favor benign, uncertain, favor carcinoma) did differentially predict (44%, 44%, 41% patients, respectively; P = 0.86) nor percentage tissue involved by No pathologic feature affected likelihood In 39% only contralateral different sextant site initial site. Conclusions. high adenocarcinoma warrants repeat Sampling should include multiple sites prostate.