Can non‐malignant biopsy features identify men at increased risk of biopsy‐detectable prostate cancer at re‐screening after 4 years?

• Published in: BJU international Vol. 101; no. 3; pp. 283 - 288
• Main Authors: Wolters, Tineke, Roobol, Monique J., Schröder, Fritz H., Van Der Kwast, Theodorus H., Roemeling, Stijn, Van Der Cruijsen‐Koeter, Ingrid W., Bangma, Chris H., Van Leenders, Geert J.L.H.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.02.2008; Blackwell
• Subjects: Aged; Biological and medical sciences; biopsy core length; Biopsy, Needle - methods; Gynecology. Andrology. Obstetrics; Humans; inflammation; Male; Male genital diseases; Medical sciences; Middle Aged; Nephrology. Urinary tract diseases; Prostate - pathology; prostate biopsy; prostate cancer; prostatic intraepithelial neoplasia; Prostatic Neoplasms - pathology; Retreatment; Retrospective Studies; Risk Assessment; Risk Factors; screening; Tumors; Tumors of the urinary system; Urinary tract. Prostate gland; biopsy core length; prostate biopsy; Nephrology; screening; Prostate disease; Male; Epidemiology; Urology; Adult; Urogenital system; Male genital diseases; Human; Premalignant lesion; Urinary system disease; Prostate intraepithelial neoplasia; Inflammation; Malignant tumor; Medical screening; Anatomic pathology; prostatic intraepithelial neoplasia; Biopsy; Length; Risk factor; Prostate cancer; Prostate; Cancer
• ISSN: 1464-4096; 1464-410X
• DOI: 10.1111/j.1464-410X.2007.07267.x

OBJECTIVES To identify pathological features in non‐malignant sextant prostate needle biopsies and assess their predictive value for detecting prostate cancer on biopsy 4 years later. PATIENTS AND METHODS We selected and reviewed the biopsy specimens of 121 men that were diagnosed as non‐malignant during the first screening round of the European Randomized Study of Screening for Prostate Cancer (ERSPC), Rotterdam section. Of these 61 (50.4%) were positive for cancer during the second round (the result of a matched random sample). The biopsies were indicated by prostate‐specific antigen levels of ≥ 3.0 ng/mL. Specimens were scored for high‐grade prostatic intraepithelial neoplasia (HGPIN), active and chronic inflammation, biopsy core length and glandular core length. The predictive value of the pathological features for detecting prostate cancer after 4 years was assessed. RESULTS In the first‐round biopsies the incidence of HGPIN was 7.1%; there was active inflammation in 22.4% and chronic inflammation in 51.0%. The mean core length was 9.3 mm and mean glandular core length 7.4 mm; the mean total biopsy length (sum of core lengths) was 56.3 mm and mean total glandular length (sum of glandular core lengths) was 44.6 mm. None of the pathological features in the initial round was significantly related to the detection of cancer in the second round. CONCLUSIONS In this study of non‐malignant prostate biopsy specimens from a screened population, no pathological features could be identified that were predictive for detecting prostate cancer on biopsy 4 years later.