OBJECTIVES: To test the hypothesis that patients with widespread high grade prostatic intra epithelial neoplasia (wHGPIN) and metabolic syndrome (MetS) are at a higher risk of prostate cancer (PCa) at a repeat biopsy.
METHODS AND MATERIALS: We prospectively evaluated 161 patients submitted from December 2004 to December 2011 to prostate rebiopsy after a initial diagnosis of HGPIN in a tertiary academic center. A 12 core biopsy template was used for all the biopsies. Rebiopsy was performed six months after the initial biopsy independently from PSA level and the DRE finding. wHGPIN was defined as≥4 biopsy cores involved. MetS was defined according to the National Cholesterol Education Program's Adult Treatment Panel III criteria.
RESULTS: Overall, 64 patients (39.7%) presented wHGPIN and 97 isolated HGPIN (60.3%). MetS was found in 63 patients, 39.1% of the whole population. Out of them 16 (25.3%) and 47 (74.7%) patients had a diagnosis of isolated and wHGPIN (P=0.001). PCa detection rate at repeat biopsy was significantly higher in patients with MetS and wHGPIN than in those with wHGPIN and no MetS (57.4% Vs 23.5%; P=0.016). A logistic regression model confirmed that wHGPIN and MetS are independent risk factors of prostate cancer diagnosis (respectively: Odds ratio (OR)= 4.187, 95%CI: 1.65-10.57 p=0.002 and OR=3.603, 95%CI: 1.41-9.19, p=0.007).
CONCLUSION: Patients with MetS and wHGPIN are at a higher risk of PCa, therefore performing a new prostate biopsy in those patients should be recommended.
Written by:
Antonio C, Francesco C, Cosimo DN, Andrea T, Rocco D. Are you the author?
Urology Unit, Magna Graecia University of Catanzaro, Catanzaro, Italy.
Reference: Urol Oncol. 2012 Dec 26. pii: S1078-1439(12)00350-X.
doi: 10.1016/j.urolonc.2012.10.004
PubMed Abstract
PMID: 23273912
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