İbrahim DUMAN, Soner GÜNEY, Serdar ARISAN, Osman Nuri AKBULUT, İlker ÇÖMEZ, Ergenekon ERBİL

Prostatic intraepithelial neoplasm: Retrospective results of clinical, histopathological approaches

Prostat kanseri ileri yaş-grubu erkeklerde en sık görülen ve en önemli ölüm sebeplerinden biridir. Prostat kanserinin tanısı konduğunda, genellikle kanser ya lokal invazyon göstermiş ya da metastatik hale gelmiştir. Günümüzde prostat kanseri için prekürsor lezyon kavramına uyan en önemli antite Prostatik Intraepitelyal Neoplazi'dir (PIN). Çalışma, prostat kanserinin erken tanısı amacıyla değerlendirme kapsamına alınan, serum PSA (Prostatik Spesifik Antijen) ve/veya PRM (Parmakla Rektal Muayene) sonucu TRUS (Transrektal Ultrasonografi) eşliğinde sextant prostat biyopsileri yapılan hastaların, klinik ve histopatolojik kayıtlarının retrospektif olarak incelenmesini içermektedir. Nisan 2001 - Eylül 2003 tarihleri arasındaki 31 aylık sürede, polikliniğimize başvuran ve prostat kanseri şüphesiyle TRUS eşliğinde prostat biyopsisi uygulanan 166 hastanın biyopsi materyallerinin histopatolojik bulguları retrospektif olarak incelendi. Prostat kanseri, yüksek grade (yg) PIN, düşük grade (dg) PIN ve BPH patolojik sonuçları; yaş, ortalama serum PSA değerleri,' PRM bulguları ve prostat kanserli hastalann Gleason grade ve Gleason skor değerleriyle karşılaştırıldı. Bu nedenle YG PIN bulguları saptanan BPH'li olguların periyodik PSA ölçümleri ve PRM ile takip edilmesini, klinik değişkenlerin varlığı durumunda biyopsi tekrarı için yemden değerlendirilmesini tavsiye ediyoruz.

Prostat intraepitel neoplazi: Klinik ve hisitopatolojik retrospektif sonuçlar

Prostate cancer is the main problem in advanced aged population and it is the major reason causing death in western countries. Frequently the tumor metastasis or locally invades tissues when it is diagnosed. The main target should be the early diagnosis of the tumor. Today, the most important precursor lesion of prostate cancer is prostate intraepithelial neoplasm (PIN) in pathological analysis. This study aims to discuss PIN diagnostic value. This study comprimised on retrospectical determination of prostate specific antigen (PSA) levels and/or digital rectal examination (DRE) and sextant biopsies with the guide of transrectal ultrasonography (TRUS). Between April 2001 and September 2003, 166 patients were included in the study. Follow- up period was 31 months. Pathological results of prostate cancer, high grade PIN (hgPIN), low grade PIN (lgPIN) BPH and age, average serum PSA levels, DRE findings, Gleason Score and Gleason Grade results for prostate cancer patients were compared. In conclusion, the patients who had hgPIN lesions with BPH advi.ced for periodic follow up for prostate specific antigen (PSA) and digital rectal examination (DRE) and in necessary conditions, rebiopsy.

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