Atypical small acinar proliferation Review of a series of 64 patients

Mallén, Eva; Álvarez, Pedro Gil; Sancho, C.; Gil, Marı́a J.; Allepuz, C.; Borque, Á.; Agua, Celia del; Rioja, L.A.

doi:10.1080/00365590600641939

Cited by 15 publications

(13 citation statements)

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“…ASAP is possibly more closely related to cancer than HGPIN [33,34] and the present results confirm that. The reported mean cancer detection rate in repeated biopsies for ASAP is ≈ 40%[13–17]. The probability for having cancer after a diagnosis of ASAP is, according to Brausi et al.…”

Section: Discussionmentioning

confidence: 99%

“…The diagnosis of atypical small acinar proliferation (ASAP) has also been correlated with the finding of prostate cancer in subsequent biopsies [13–17]. Indeed, the term was coined to focus attention in cases not completely fulfilling the minimal criteria of prostate cancer [18], thus advising a close follow‐up.…”

Section: Introductionmentioning

confidence: 99%

“…Indeed, the term was coined to focus attention in cases not completely fulfilling the minimal criteria of prostate cancer [18], thus advising a close follow‐up. Also, there are various reported rates and opinions of the association between ASAP and subsequent prostate cancer [13–17].…”

Section: Introductionmentioning

confidence: 99%

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Prostate adenocarcinoma detected after high‐grade prostatic intraepithelial neoplasia or atypical small acinar proliferation

López

2007

BJU International

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OBJECTIVE To review specific histological variables in patients with prostate cancer who previously had diagnoses of high‐grade prostatic intraepithelial neoplasia (HGPIN) and/or atypical small acinar proliferation (ASAP), compared with those who had no such diagnoses. PATIENTS AND METHODS The histological characteristics of prostate cancers which were detected after a previous diagnosis of HGPIN and/or ASAP during 1998–2005 were investigated and correlated with the biopsies from patients with prostate cancer but with no such previous diagnoses. RESULTS HGPIN was followed by prostate cancer on repeat biopsy in 16.8% of patients, and ASAP in 26.7%. The mean age of patients with HGPIN or ASAP was higher than in those with no such diagnoses (P < 0.001). Similarly, patients with these previous diagnoses had a lower Gleason score (P = 0.017 and <0.001, respectively) and lower tumour volume variables (fewer tumour foci, P = 0.033 and 0.041, respectively) and shorter cancer (P = 0.048 and 0.030) in core biopsies than those without. CONCLUSIONS Patients with prostate cancer who had previous biopsies with HGPIN or ASAP were older and has lower grade‐ and volume‐cancers than those who had not.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prostate adenocarcinoma detected after high‐grade prostatic intraepithelial neoplasia or atypical small acinar proliferation

López

2007

BJU International

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“…Several studies revealed that the cancer detection rate in initial ASAP patients ranged from 34% to 60%. ASAP was highly predictive of a cancer diagnosis with a subsequent biopsy compared to the detection rate of initial HGPIN with a subsequent biopsy, which was reported from 2% to 47% 3‐5 . Although the diagnosis of ASAP has also been correlated with findings of prostate cancer in subsequent biopsies, the exact diagnostic criteria for ASAP has not been established.…”

Section: Introductionmentioning

confidence: 99%

Atypical small acinar proliferation of prostate: Follow-up study of 114 patients

Lee

Choi

Yun

et al. 2011

Basic and Applied Pathology

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Background and aim: Atypical small acinar proliferation (ASAP) is defined as atypical foci suspicious for but not diagnostic of malignancy. ASAP is known as a strong predictive factor associated with prostate cancer. Because the diagnostic criteria for ASAP are subjective, objective diagnostic criteria were applied for ASAP as follows: (i) total loss of basal cells confirmed by immunohistochemistry and inconspicuous nucleoli; and (ii) a minute (≤500 micrometer in length) focus of atypical glands with total loss of basal cells and prominent nucleoli. Methods: To evaluate the cancer detection rate of ASAP diagnosed by objective diagnostic criteria, 114 patients initially diagnosed with ASAP were reviewed. Results: ASAP was noted in 2.17% of prostate biopsy cases. Eighty‐one patients were successfully followed up. Twenty patients (24.7%) were finally diagnosed as having adenocarcinoma by subsequent biopsy. According to the criteria, we subclassified ASAP into two groups: ASAP (not otherwise specified [NOS]) and ASAP (suspicious microscopic adenocarcinoma). ASAP (NOS) and ASAP (suspicious microscopic adenocarcinoma) showed significantly different cancer detection rates (20.3% vs 71.4%) at subsequent biopsies (P= 0.003). Sixteen patients underwent radical prostatectomy, and 13 cases (81.2%) were categorized as clinically significant prostate cancer. Conclusions: The presence of ASAP in needle biopsy was evaluated to be an important predictor of cancer.

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“…Therefore, most authors believe that ASAP is a diagnostic risk category and not a valid pathologic entity. [60][61][62][63][64] Its precise diagnostic cri- Fig 15. -Atypical small acinar proliferation. This focus is too small and nuclear detail is too obscured by hyperchromasia to definitively render a diagnosis of carcinoma (hematoxylin-eosin, magnification ×400).…”

Section: Atypical Small Acinar Proliferationmentioning

confidence: 99%

Premalignant and Malignant Prostate Lesions: Pathologic Review

Dickinson

2010

Cancer Control

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Background High-grade prostatic intraepithelial neoplasia (HGPIN) is currently the only recognized premalignant lesion of prostatic carcinoma. Methods This review article discusses HGPIN, its link to prostatic adenocarcinoma, and the significance of its presence on needle biopsy. The criteria and clinical impact of the diagnosis of atypical small acinar proliferation on needle biopsy are reviewed. Certain subtypes of prostate cancer that are not associated with HGPIN are of clinical relevance, and the unique clinicopathologic features of these subtypes are discussed. Histologic variants of prostatic adenocarcinoma with distinct cell types are also described. Results HGPIN is the only known pathologic factor currently available to distinguish which patients may be at risk for detecting carcinoma on repeat biopsy. Histologic variants are recognized due to the inference of a particular Gleason grade pattern associated with the cell type, hence affecting prognosis. Typically, pure forms of these histologic variants are associated with worse prognosis due to the associated high Gleason grades. Conclusions HGPIN has a strong association with acinar-type prostatic adenocarcinoma. HGPIN and acinar-type prostatic adenocarcinoma both show similar molecular alterations, providing further evidence of their association.

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Atypical small acinar proliferation Review of a series of 64 patients

Cited by 15 publications

References 13 publications

Prostate adenocarcinoma detected after high‐grade prostatic intraepithelial neoplasia or atypical small acinar proliferation

Prostate adenocarcinoma detected after high‐grade prostatic intraepithelial neoplasia or atypical small acinar proliferation

Atypical small acinar proliferation of prostate: Follow-up study of 114 patients

Premalignant and Malignant Prostate Lesions: Pathologic Review

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