Atypical small acinar proliferation and its significance in pathological reports in modern urological times

Tsampoukas, Georgios; Manolas, Victor; Brown, Dominic; Dellis, Athanasios; Deliveliotis, Konstantinos; Moussa, Mohamad; Papatsoris, Athanasios

doi:10.1016/j.ajur.2021.04.008

Cited by 5 publications

(5 citation statements)

References 52 publications

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“…The presence of this lesion may be a source of concern for both the pathologist and the urologist in terms of making the correct diagnosis, detecting the cancer and determining follow-up intervals. ASAP, which is not a precancerous lesion, is actually a cause of high suspicion for prostate carcinoma when histopathological data are not sufficient to make a diagnosis of the prostate cancer or the tissue cannot be adequately sampled [ 19 ]. The most important reason for this situation is that ASAP shows a low degree of atypia and has very few atypical glands [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Expression of nectin-4 in prostate cancer

Ordu

2023

North Clin Istanbul

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OBJECTIVE Nectin-4 is a transmembrane protein belonging to the nectin family of immunoglobulin-like molecules which is found in the placenta and trachea under physiological conditions and its expression has been shown in many cancer types. We aimed to investigate for the 1 st time nectin-4 expression in human prostate cancer tissues. METHODS We retrospectively analyzed the prostate pathology specimens of 82 patients who underwent initial transrectal ultrasound-guided prostate biopsy or transurethral prostate resection and were found to have atypical small acinar proliferation (ASAP) and incidentally prostate cancer. Tissue samples with prostatic cancer were used as a control for alpha-methylacyl-CoA racemase (AMACR), and benign prostatic glands in the same tissue provided the negative control. The intensity and extent of nectin-4 expression were determined microscopically using the histochemical scoring system which was defined as the product of the staining intensity (score: 0–3) and percentage of stained cells (0–100) at a given intensity. RESULTS We conducted immunohistochemical analysis of nectin-4 and AMACR expression in all 82 samples. While AMACR expression was positive in prostate cancer tissues with a GS of <7 (n=24, 100%), 7 (n=18, 100%), and ≥8 (n=15, 100%), it was negative in all ASAP samples (n=25, 100%) (p<0.001). Nectin-4 expression was not detected in any of the GS <7, GS 7, or GS ≥8 samples but was found in benign prostatic gland tissues and all 25 (100%) ASAP samples (p<0.001). CONCLUSION We found that nectin-4 was not expressed in prostate cancer tissues but was expressed in ASAP-and benign prostate gland containing tissues. We believe that prospective studies with more patients and samples including radical prostatectomy materials will reveal the relationship between nectin-4 and prostate cancer more clearly.

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Section: Discussionmentioning

confidence: 99%

Expression of nectin-4 in prostate cancer

Ordu

2023

North Clin Istanbul

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“…Evidence indicates that ASAP tends to be an incipient disease or even a benign lesion. First, in pathology, ASAP is regarded as an ambiguous report that might predict either benign lesions mimicking malignancy or undersampled prostate cancer [39]. In a previous study, ambiguous p63 (+) expression was detected in immunohistochemical tests and other architectural or cytological changes in ASAP, which could be identified in non-cancerous tissues [40].…”

Section: Discussionmentioning

confidence: 99%

“…A study led by Dima confirmed that in MRI/TRUS fusion-guided biopsy, cores that re-target areas of previous ASAP are more effective than random re-biopsy cores [38]. Regarding the approach of repeat biopsy, transperineal biopsy is preferable because it is capable of getting samplings that cannot be reached by transrectal biopsy [39].…”

Section: Discussionmentioning

confidence: 99%

The Rate of Clinically Significant Prostate Cancer on Repeat Biopsy after a Diagnosis of Atypical Small Acinar Proliferation: A Systematic Review and Meta-Analysis

Ji,

Jin,

Wang

2023

Oncology

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Introduction: Atypical small acinar proliferation (ASAP) is detected in approximately 5% of prostate biopsies. Current guidelines recommend a repeat biopsy within 3–6 months after the initial diagnosis. However, clinical significance and outcomes of repeat biopsy are conflicting. Based on this situation, we conducted a meta-analysis to report the rate of clinically significant prostate cancer (csPCa) on repeat biopsy after a diagnosis of atypical small acinar proliferation (ASAP) to determine the safety and validity of deferring repeat biopsy. Methods: We searched PubMed, Medline, Web of Science, and Embase databases for articles published until July 2023. Two reviewers independently screened the literature, extracted the data, and assessed the risk of bias for the included studies. Pooled ratios and 95% confidence intervals (CIs) were calculated using Stata 17. Results: Sixteen studies and 1,796 patients were included in the meta-analysis. A total of 553 patients were diagnosed with prostate cancer, and 204 had csPCa. The pooled rate of csPCa on repeat biopsy after ASAP diagnosis was 12.1% (95%CI: 0.09, 0.15), which is a relatively low progression rate. However, we observed heterogeneity among the 16 articles. Subgroup analysis was performed, and patients who underwent repeat biopsy within 6 months according to the guidelines had a lower csPCa incidence (effective size (ES)=0.09, 95%CI: 0.060, 0.120) than those who underwent biopsy after more than 6 months (ES=0.221, 95%CI: 0.094, 0.349). Conclusion: Repeat biopsy can be safely deferred for patients diagnosed with ASAP. We believe our results may help to improve management strategies and encourage clinicians to choose more patient-friendly or non-invasive diagnostic evaluations.

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“…Although being well tolerated and accumulating in plasma over a year, a standardized, decaffeinated catechin mixture comprising 400 mg of EGCG per day did not diminish the risk of prostate cancer in men who had high-grade prostatic intraepithelial neoplasia (HGPIN) and/or atypical small acinar proliferation (ASAP) at the start of the study [ 320 ]. However, ASAP was never identified as a pre-neoplastic lesion in the context of prostate cancer [ 321 , 322 ]. When the same data from Kumar et al [ 320 ] was analyzed without the ASAP lesions but with the HGPIN lesions, the reduction in PCa progression was approximately 50% according to a Kaplan-Meyer analysis.…”

Section: Egcg In Cancer Prevention and Therapy?mentioning

confidence: 99%

Epigallocatechin-3-Gallate Therapeutic Potential in Cancer: Mechanism of Action and Clinical Implications

Kciuk,

Alam,

Ali

et al. 2023

Molecules

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Cellular signaling pathways involved in the maintenance of the equilibrium between cell proliferation and apoptosis have emerged as rational targets that can be exploited in the prevention and treatment of cancer. Epigallocatechin-3-gallate (EGCG) is the most abundant phenolic compound found in green tea. It has been shown to regulate multiple crucial cellular signaling pathways, including those mediated by EGFR, JAK-STAT, MAPKs, NF-κB, PI3K-AKT-mTOR, and others. Deregulation of the abovementioned pathways is involved in the pathophysiology of cancer. It has been demonstrated that EGCG may exert anti-proliferative, anti-inflammatory, and apoptosis-inducing effects or induce epigenetic changes. Furthermore, preclinical and clinical studies suggest that EGCG may be used in the treatment of numerous disorders, including cancer. This review aims to summarize the existing knowledge regarding the biological properties of EGCG, especially in the context of cancer treatment and prophylaxis.

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Atypical small acinar proliferation and its significance in pathological reports in modern urological times

Cited by 5 publications

References 52 publications

Expression of nectin-4 in prostate cancer

Expression of nectin-4 in prostate cancer

The Rate of Clinically Significant Prostate Cancer on Repeat Biopsy after a Diagnosis of Atypical Small Acinar Proliferation: A Systematic Review and Meta-Analysis

Epigallocatechin-3-Gallate Therapeutic Potential in Cancer: Mechanism of Action and Clinical Implications

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