title: Predicting prostate cancer at rebiopsies in patients with high-grade prostatic intraepithelial neoplasia: a study on 546 patients.
abstract: The aim of this study was to analyse the factors that predict the diagnosis of prostate cancer (PCa) after high-grade prostatic intraepithelial neoplasia (HGPIN). Data from 546 patients with HGPIN submitted up to a 6-month series of three rebiopsies, according to an institutional protocol, were reviewed. PCa has been found in 174 cases (31.8%), in 116 cases at the first and in 58 cases at a further rebiopsy. The risk of finding PCa at the first rebiopsy was correlated with the PSA value and with an anomalous digital rectal examination (DRE) at the time of the initial biopsy; the risk at a subsequent rebiopsy was correlated to the number of cores with HGPIN, with a cutoff of four, and to the ratio with the total number of cores ('PIN density'), with a cutoff of 50%, at the time of initial biopsy. A tailored protocol of controls can be suggested: (a) higher PSA value and/or anomalous DRE: early extended or saturation rebiopsy; (b) number of cores with HGPIN ≥4 and/or PIN density ≥50%: delayed rebiopsy; and (c) no risk factors: PSA and DRE controls.
authors.affiliation: Department of Urology, University of Brescia, Spedali Civili Hospital, Brescia, Italy. alxanto@hotmail.com
authors.forename: A
authors.initials: A
authors.lastname: Antonelli
authors.forename: R
authors.initials: R
authors.lastname: Tardanico
authors.forename: L
authors.initials: L
authors.lastname: Giovanessi
authors.forename: N
authors.initials: N
authors.lastname: Pesenti
authors.forename: L
authors.initials: L
authors.lastname: Gatti
authors.forename: T
authors.initials: T
authors.lastname: Zambolin
authors.forename: D
authors.initials: D
authors.lastname: Zani
authors.forename: S C
authors.initials: SC
authors.lastname: Cunico
authors.forename: C
authors.initials: C
authors.lastname: Simeone
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis; D001706:Biopsy / Q000379:methods; D002985:Clinical Protocols; D051517:Digital Rectal Examination; D055088:Early Detection of Cancer / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011467:Prostate / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000032:analysis; D019048:Prostatic Intraepithelial Neoplasia / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000473:pathology*; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen