Purpose: We investigated the prognosis and outcome of atypical small acinar proliferation (ASAP) and extensive high grade prostate intraepithelial neoplasm (PIN) in prostate cancer detection in Taiwan.
Materials and Methods: We retrospectively reviewed our prostate biopsy database containing data acquired over a 20-year period in National Taiwan University Hospital. Data collection was done by chart review. We analyzed patient in this study period with pathology reports including atypical glands, atypical small acinar proliferation, prostatic intraepithelial neoplasia after receiving prostate biopsy.
Results: A total of 66 patients were enrolled. 38 patients initially had atypical glands/ atypical small acinar proliferation; 26 patients initially had prostatic intraepithelial neoplasia; and 2 patient had atypical small acinar proliferation as well as prostatic intraepithelial neoplasia. 14 (36.8%) patients in ASAP group were later diagnosed as prostate cancer, 6 (23.1%) patients in PIN group were later diagnosed as prostate cancer, and 100% patients in ASAP+PIN group were later diagnosed as prostate cancer.
Conclusion: Patients with a diagnosis of ASAP or extensive high grade PIN during prostate biopsy had a higher chance of developing prostate cancer, especially for patients with a simultaneous diagnosis of ASAP + PIN in the same biopsy. These patients should receive second time biopsy during follow up. Most cancer of the cancer in these patients could be detected within twice re-biopsy.