ABSTRACT

The incidence of the prostate adenocarsinome (PCA) in the repeat prostate biopsy after the high grade prostatic intraepithelial neoplasia (HGPIN) diagnosis has decreased with the increase of the quadrant numbers. Contrary to the former literature, PCA incidence after the HGPIN diagnosis was not increased as compared to cases without HGPIN. In this study the re-biopsy results of the patients whose first prostate biopsy results were HGPIN were evaluated.

A total of 2.758 patients who underwent transrectal ultrasound guided prostate biopsy in our institude between January 2005 to June 2013 due to increased prostate spesific antigen (PSA) levels or abnormal digital rectal examination results were examined and 353 of these patients with the diagnosis of HGPIN were included in the study. Under local anesthesia, 10 cores taken in the first and 12 cores taken in the second biopsies.

From the 353 patients whose first prostate biopsy pathology was HGPIN, 100 of them underwent repeat prostate biopsy. It was found that 48% of these patients had benign (prostate tissues and prostatitis), 21% had HGPIN, 11% of them had malignancy suspected focus and 20% patients had PCA. The patients whose re-biopsy results revealed PCA 20 patients and the other 80 patients had no significant difference in age, PSA, PSA density, digital rectal examination finding and number of HGPIN focus in the first biopsy. However, in patients with positive HGPIN in ≥4 quadrants PCA rate was 35% and was 17% in patients with positive HGPIN in ≤3 quadrants.

The incidence of PCA in the re- biopsies of patients in whom first biopsy results revealed HGPIN was not different from other cases. Patients with positive HGPIN in ≥4 cores should be followed-up closely and evaluated for re-biopsy.