Extent of Prostatic Atrophy in Needle Biopsies and Serum PSA Elevation: Is There an Association with the Type of Atrophy?
A Billis, L Meirelles, LLL Freitas, F Rogerio, RV Oliveira, L Schultz, MG Fazuoli, MN Bronner, LA Magna. School of Medicine, University of Campinas (Unicamp), Campinas, SP, Brazil
Background: In a previous published study we found a positive and significant association between extent of atrophy and free or total serum PSA elevation in prostate needle biopsies without the presence of cancer, high-grade PIN, or areas suspicious for cancer. The aim of this study is to find any possible association with the type of atrophy.
Design: The study was based on 75 needle biopsies. The only diagnosis in all biopsies was focal atrophy (partial or complete) without the presence of cancer, high-grade PIN, or areas suspicious for cancer. The subtypes of complete atrophy were classified according to a previous published study as simple, postatrophic hyperplasia, and sclerotic. The extent of atrophy was measured in two ways: the linear extent in millimeters and the percentage of linear extent showing atrophy for each biopsy. Spearman's coefficient of rank correlation and the qui-square test were used for the statistical analyses.
Results: The number of cores examined for each biopsy ranged from 7 to 18 (mean 9.4, median 8). The linear extent of atrophy ranged from 0.5 to 38 mm (mean 11, median 9.5). The percentage of linear extent ranged from 0.82% to 49% (mean 17.6, median 16.8). A positive and statistically significant correlation was found between atrophy extent and free or total serum PSA level (p<0.01). Based on the median value of PSA, the biopsies were divided in 2 groups: A) 8.2ng/mL, and B) > 8.2ng/mL. The total extent of atrophy was 321mm and 507.5mm in groups A and B, respectively. Partial atrophy, simple atrophy, postatrophic hyperplasia, and sclerotic atrophy corresponded to 12.8%, 53.9%, 19.9%, and 13.7% of the total extent in group A; and, 10.0%, 59.4%, 25.9%, and 4.7% in group B. There was no statistically significant difference in the distribution between the groups (p=0.13).
Conclusions: A positive and significant association was found between extent of atrophy and free or total serum PSA elevation confirming our previous study. This elevation is not related to the type of atrophy. We speculate that injurious stimuli causing atrophy, independent of the type of atrophy, may interfere in the physiologic barrier that prevent the escape of any significant amounts of PSA to the general circulation.
Category: Genitourinary (including renal tumors)
Wednesday, March 11, 2009 9:30 AM
Poster Session V # 113, Wednesday Morning