Is there any clinical parameter able to predict prostate cancer after initial diagnosis of atypical small acinar proliferation?
BACKGROUND
Tissue samples from prostate biopsy may contain atypical small acinar proliferation (ASAP): present guidelines recommend a repeat biopsy policy. This study attempted to identify clinical patterns that help predict cancer detection at second biopsy.


METHODS
From 1999 to 2005, 1,274 patients underwent a prostate biopsy: in 5.9% ASAP was found, and patients underwent a second biopsy. Uni- and multivariate analysis compared the clinical patterns of cancer patients with the no cancer group at second biopsy.


RESULTS
Univariate analysis showed significant differences in PSA ratio density, prostate volume, final PSA values and Delta PSA; at multivariate logistic regression analysis, only PSA ratio (OR = 0.743, 95% CI 0.620-0.891) and prostate volume (OR = 0.960, 95% CI 0.924-0.998) were predictive of malignancy.


CONCLUSIONS
In our experience, PSA ratio and prostate volume seem to be independent predictors of prostate cancer at re-biopsy.
Mearini
Luigi
L
Department of Medical-Surgical Specialties and Public Health, Section of Urology and Andrology, University of Perugia, Perugia, Italy. luigi.mearini@tin.it
Costantini
Elisabetta
E
Bellezza
Guido
G
Cavaliere
Antonio
A
Zucchi
Alessandro
A
Bini
Vittorio
V
Porena
Massimo
M
D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D049109:Cell Proliferation; D006801:Humans; D008297:Male; D008495:Medical Oncology / Q000379:methods; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D017430:Prostate-Specific Antigen / Q000096:biosynthesis; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000473:pathology*; D012372:ROC Curve; D012044:Regression Analysis; D012680:Sensitivity and Specificity
D017430:Prostate-Specific Antigen