Imanaka Takahiro, Yoshida Takahiro, Taniguchi Ayumu, Yamanaka Kazuaki, Kishikawa Hidefumi, Nishimura Kenji
Department of Urology, Hyogo Prefectural Nishinomiya Hospital, Nishinomiya, Hyōgo 662-0918, Japan.
Mol Clin Oncol. 2020 Dec;13(6):67. doi: 10.3892/mco.2020.2137. Epub 2020 Sep 17.
Current guidelines recommend a repeat biopsy within 3-6 months after an initial diagnosis of atypical small acinar proliferation (ASAP) due to the high incidence of cancer detection on repeat biopsy. The current study sought to investigate practice patterns after a diagnosis of ASAP in a real-world setting and examine the clinicopathological outcomes of repeat biopsy. The departmental database of the Hyogo Prefectural Nishinomiya Hospital identified 97 of 1,218 patients with a diagnosis of ASAP on initial biopsy from 2011 to 2016. Clinical and pathological data were retrospectively analyzed. Of the 97 patients, 34 (35.1%) underwent a repeat biopsy. Patients with a repeat biopsy had a significantly higher prostate-specific antigen (PSA) velocity and shorter PSA doubling time than patients without a repeat biopsy (P=0.0002), and of these 34 patients with a repeat biopsy, 16 (47.1%) were diagnosed as having cancer. Multivariate logistic regression analysis revealed that a small prostate (P=0.0250) and advanced age (P=0.0297) were associated with cancer detection on repeat biopsy. Of the 16 cancers identified, 13 (81.6%) were diagnosed with a Gleason score >6. The results indicated that the implementation of a repeat biopsy for patients with ASAP could be affected by clinical characteristics in real-world settings, despite the current recommendation of guidelines endorsing immediate repeat biopsy. Prostate volume and age would aid in the decision-making process to perform repeat biopsy in patients with high PSA velocity and short PSA doubling time after a diagnosis of ASAP.
由于重复活检时癌症检出率高，当前指南建议在首次诊断非典型小腺泡增生（ASAP）后的3 - 6个月内进行重复活检。本研究旨在调查在现实环境中诊断ASAP后的实际操作模式，并检查重复活检的临床病理结果。兵库县西宫医院的科室数据库确定了2011年至2016年1218例首次活检诊断为ASAP的患者中的97例。对临床和病理数据进行了回顾性分析。在这97例患者中，34例（35.1%）接受了重复活检。接受重复活检的患者比未接受重复活检的患者具有显著更高的前列腺特异性抗原（PSA）速度和更短的PSA倍增时间（P = 0.0002），在这34例接受重复活检的患者中，16例（47.1%）被诊断患有癌症。多因素逻辑回归分析显示，前列腺体积小（P = 0.0250）和年龄大（P = 0.0297）与重复活检时癌症检出相关。在确诊的16例癌症中，13例（81.6%）的Gleason评分>6。结果表明，尽管当前指南建议立即进行重复活检，但在现实环境中，ASAP患者重复活检的实施可能会受到临床特征的影响。前列腺体积和年龄将有助于在诊断ASAP后PSA速度高和PSA倍增时间短的患者中进行重复活检的决策过程。
