Abdülmüttalip ŞİMŞEK, Faruk ÖZGÖR, Onur KÜÇÜKTOPÇU, Mehmet Fatih AKBULUT, Murat ŞAHAN, Ali SEZER, Ömer SARILAR, Zafer Gökhan GÜRBÜZ

Yüksek dereceli intraepitelyal neoplazi ve atipik küçük asiner proliferasyonun prostat biyopsisinde öneminin değerlendirilmesi

Amaç: Transrektal ultrason eşliğinde prostat biyopsisi yapılan hastalarda biyopsi sonuçlarımızı açıklamak ve patolojisi atipik küçük asiner proliferasyon ASAP veya yüksek dereceli intraepitelyal neoplazi HGPIN gelen hastalarda tekrar biyopsinin önemini vurgulamakGereç ve Yöntemler: Kliniğimizde Ekim 2007 ile Nisan 2013 tarihleri arasında 1763 hastaya yaptığımız transrektal ultrason eşliğinde prostat biyopsisi TRUS-Bx işleminin verileri geriye dönük olarak değerlendirildi. Değerlendirilen 1763 TRUS-Bx işleminin, 73’inin ikinci kez tekrarlayan biyopsi, 6’sının ise üçüncü kez tekrarlayan biyopsi olduğu görüldü. Biyopsi raporuna ulaşılamayan ve/veya PSA değeri saptanamayan 338 hasta çalışma dışı tutuldu. Çalışmaya dahil edilen tüm biyopsi işlemlerinin toplam 1337 hastaya uygulandığı görüldü. Hastalar ilk patoloji sonuçlarına göre 6 gruba ayrıldı.Bulgular: İlk biyopside hastaların %25,4’ ünün adenokanser tanısı aldığı görüldü. Hastaların %0,5’ inde birden çok odakta HGPIN ; %7,1’ inde ASAP saptandı ve %0,2’sinde ASAP ile beraber HGPIN görüldü. Bu üç gruptaki hastaların tekrar biyopsilerinde adenokanser saptanma oranları sırasıyla %40, %31 ve %50 olarak bulundu. Sonuç: Patolojilerinde HGPIN ve/veya ASAP bulguları olan hastalar yakın takibe alınmalı, bu patolojik bulguların önemi hakkında hastalar bilgilendirilip, takibe devam etmeleri ve uygun görülen zamanlarda tekrar biyopsilerinin yapılması konusunda ikna edilmelidir

Anahtar Kelimeler:

ASAP, HGPIN, prostat biyopsi

Assessing the significance of high grade prostatic intraepithelial neopasia and atypical small acinar proli- feration in prostate biopsy

Objective: To evaluate pathological results of patients who underwent transrectal ultrasonography guided prostate biopsy and rebiopsy of patients with atypical small acinar proliferation ASAP and high grade intraepithelial neoplasia HGPIN .Material and Methods: We evaluated 1763 pathology results of transrectal ultrasonography guided prostate biopsy between October 2007 and April 2013. Of these 1763 pathology results, 73 of patients were underwent re biopy and 6 of them were underwent third biopsy. Total of 338 patients without a proper pathology result and results with no PSA value were ruled out from study. Pathology results included into the study were performed on 1337 patients. Patients were grouped in to 6 groups according to their first pathology results.Results: According to the first pathology result 25.4% of patients were enrolled into adenocancer group. High grade intraepithelial neoplasia more than one focus, ASAP and ASAP+HGPIN were seen 0.5%, 7.1% and 0.2% of patients, respectively. Re biopsy of these 3 groups detected adenocancer 40%,31% and 50% in orderly.Conclusion: Patients with pathology results of HGPIN and/or ASAP should be followed up carefuly and patients should be informed about the importance of rebiopsy

Keywords:

ASAP, HGPIN, prostate biopsy,

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