Prostatın kansere yolculuğunda atipik küçük asiner proliferasyonların önemi nedir?
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Date
2013-04-15
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Uludağ Üniversitesi
Abstract
Transrektal ultrasonografik prostat iğne biyopsilerinde tanıda güçlük yaratan lezyonlardan biri de “atipik küçük asiner proliferasyon” (ASAP) olarak tanımlanan odaklardır. Tanı alanındaki gelişmeler nedeniyle patologlar bu lezyonla daha sık karşılaşmaktadır. Çalışmamızda Şubat 2005 – Haziran 2012 tarihleri arasında prostat iğne biyopsileri ve transüretral prostat rezeksiyonu (TUR-P) materyallerinin histopatolo jik incelemesinde ASAP tanısı verilmiş 23 hasta incelenmiştir. Bu tanının daha sonra yapılan tekrar biyopsileri ve prostatektomi materyalle rinin histopatolojik inceleme sonuçlarıyla korelasyonu araştırılmıştır. Buna göre ASAP tanısı aldıktan sonra tekrar biyopsileri ve TUR-P işlemi yapılan 23 hastadan 9’unda (%39) adenokarsinom saptanmıştır. Bu hastalarda ASAP tanısı verilen prostat kadranları ile tekrar biyop silerdeki adenokarsinom kadranları arasında farklılıklar olduğu dikkat çekici bir bulgu olarak karşımıza çıkmıştır. Sonuç olarak çalışmamız, prostat iğne biyopsilerinde ASAP tanısı alan hastaların takibinin önemli orandaki kanser riski nedeniyle mutlaka tüm kadranları içeren tekrar biyopsileriyle yapılması gerektiğini ortaya koymuştur.
Atypical small acinar proliferation (ASAP) is one of the lesions which cause difficulties in the diagnosis of transrectal ultrasonographic prostate needle biopsies. The pathologist come across with these lesions more frequently due to the developments in the diagnosis area. In this study, 23 patients, who have been diagnosed with ASAP by prostate needle biopsy and by the histopathologic examination of tran suretral prostate resection (TUR-P) materials, between February 2005 and June 2012, were analyzed. The correlation of this diagnosis with the histopathological examination results of repeated biopsy and prostatectomy materials was investigated. Accordingly, adenocarcinoma was diagnosed in 9 patients out of 23 patients, who had repeated biopsy and TUR-P after being diagnosed as ASAP. It was a striking discov ery that, in these patients, there were differences between the prostate quadrants of that diagnosed as ASAP and the adenocarcinoma quad rants which were diagnosed with repeated biopsy. In conclusion, our study revealed that the patients who are diagnosed as ASAP by prostate needle biopsy, should be followed with repeated biopsy of all quadrants due to the significant risk of cancer.
Atypical small acinar proliferation (ASAP) is one of the lesions which cause difficulties in the diagnosis of transrectal ultrasonographic prostate needle biopsies. The pathologist come across with these lesions more frequently due to the developments in the diagnosis area. In this study, 23 patients, who have been diagnosed with ASAP by prostate needle biopsy and by the histopathologic examination of tran suretral prostate resection (TUR-P) materials, between February 2005 and June 2012, were analyzed. The correlation of this diagnosis with the histopathological examination results of repeated biopsy and prostatectomy materials was investigated. Accordingly, adenocarcinoma was diagnosed in 9 patients out of 23 patients, who had repeated biopsy and TUR-P after being diagnosed as ASAP. It was a striking discov ery that, in these patients, there were differences between the prostate quadrants of that diagnosed as ASAP and the adenocarcinoma quad rants which were diagnosed with repeated biopsy. In conclusion, our study revealed that the patients who are diagnosed as ASAP by prostate needle biopsy, should be followed with repeated biopsy of all quadrants due to the significant risk of cancer.
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Keywords
ASAP, Prostat lezyonları, Prostat iğne biyopsisi, Prostate needle biopsy, Prostate lesions
Citation
Altıntaş, E. K. vd. (2013). "Prostatın kansere yolculuğunda atipik küçük asiner proliferasyonların önemi nedir?". Uludağ Üniversitesi Tıp Fakültesi Dergisi, 39(2), 73-77.