Peculiarities of secondary biopsy in patients with prostatic intraepithelial neoplasia

Keywords: prostatic intraepithelial neoplasia; cancer of prostatic gland; biopsy


Objective. To determine the optimal quantity of the biopsy columns in cases, suspicious for prostatic gland cancer (PGC) and optimal terms for conduction of secondary biopsy of prostatic gland (PG) in patients with prostatic intraepithelial neoplasia (PIN).

Materials methods. Results of a three-year follow-up of 166 patients with PIN, in whom the diagnosis was established, using pancreatic biopsy and taking of 6 - 18 columns of the tissue.

Results. Of 166 patients with PIN in 58 (34.9%) PGC was revealed. The least (23.1%) rate of the PGC revealing was in patients, in whom a 12-points primary biopsy was performed. The biggest (62.5%) rate of the PGC revealing was in patients, in whom a 6-point primary biopsy was conducted. After a 6-point biopsy a majority cases of the PGC observation were registered during a first year. After a 12-point biopsy with the probes taken from more than 12 points a PGC was revealed most frequently on the third year. In patients after the biopsy taken with obtaining of 8 - 10 columns of the PG tissue the PGC was revealed during a second year.

Conclusion. Optimal quantity of the tissue biopsy probes was 12 columns, optimal terms for secondary biopsy constitute 6 - 12 mo after performance of a 6-point biopsy and 24 - 36 mo - after the 12-pointed and more procedure.


1. Kolesnik OO, Fedorenko ZP, Hulak LO, Mykhaylovych YuY, Horokh YeL. Rak v Ukrayini, 2016-2017. Byuleten' Natsional'noho kantser-reyestru Ukrayiny. 2018;18. [In Ukrainian].

2. Haffner M, Barbieri C. Shifting paradigms for high-grade prostatic intraepithelial neoplasia. European Urology. 2016;69(5):831-3 doi: 10.1016/j.eururo.2015.10.031.

3. Taneja S, Morton R. Prostate cancer diagnosis among men with isolated high-grade intraepithelial neoplasia enrolled onto a 3-year prospective phase III clinical trial of oral toremifene. J Clin Oncol. 2013;31:523-9. doi: 10.1200/JCO.2012.41.7634.

4. De Nunzio C, Albissini S, Cicione A, Gacci M. Widespread High-grade Prostatic Intraepithelial Neoplasia on biopsy predicts the Risk of Prostate Cancer. Archivio Italiano di Urologia e Andrologia. 2013;85(2):59-64 doi: 10.4081/aiua.2013.2.59.

5. Tao Z, Shi A. Epidemiology of prostate cancer: current status. European review for Medical and Pharmakological Sciences. 2015;19:805-12.

6. Bastaros J, Plaser J, Celma A. Current significance of the finding of high grade prostatic intraepithelial neoplasia in the prostate biopsy. Prostate Cancer Detection and Screening. 2014;38(4):270-5 doi: 10.1016/j.acuro.2013.10.001.

7. Merrimen J, Evans A. Preneoplasia in the prostate gland with emphasis on high grade prostatic intraepithelial neoplasia. Pathology. 2013;45:251-63 doi: 10.1097/PAT.0b013e32835f6134.

8. Oznur M, Koca S. Inverted (hobnail) high grade prostatic intraepithelial neoplasia and invasive inverted pattern. Oncology letters. 2015;10:2395-9 doi: 10.3892%2Fol.2015.3584.

9. Nelson A, Harvey R, Parker R, Kastner C, Doble A, Gnanapragasam V. Repeat prostate biopsy strategies after initial negative biopsy: meta-regression comparing cancer detection of transperineal, transrectal saturation and MRI guided biopsy. PLoS One. 2013;8(2):e57480. doi: 10.1371/journal.pone.0057480

10. Sonn G, Chang E, Natarajan S, Margolis D, Macairan M, Lieu P. Value of targeted prostate biopsy using magnetic resonance-ultrasound fusion in men with prior negative biopsy and elevated prostate-specific antigen. Eur Urol. 2014;65(4):809-15. doi:10.1016%2Fj.eururo.2013.03.025.

11. Wiener S, Haddock P, Cusano J, Staff I, McLaughlin T, Wagner J. Incidence of Clinically Significant Prostate Cancer After a Diagnosis of Atypical Small Acinar Proliferation, High-grade Prostatic Intraepithelial Neoplasia, or Benign Tissue. 2017;110:161-5. doi: 10.1016/j.urology.2017.08.040.

12. Tosoian J, Mamawala M, Epstein J, Landis P, Wolf S, Trock B, et al. Intermediate and Longer-Term Outcomes From a Prospective Active-Surveillance Program for Favorable-Risk Prostate Cancer. J Clin Oncol. 2015;33:3379-85 doi: 10.1200/JCO.2015.62.5764.

13. Savdie R, Aning J, So A, Black P, Gleave M. Identifying intermediate-risk candidates for active surveillance of prostate cancer. Urol Oncol. 2017;35(10):605. doi: 10.1016/j.urolonc.2017.06.048.

14. Kim T, Shin S. Multiple cores of high grade prostatic intraepithelial neoplasia and any core of atypia on first biopsy are significant predictor for cancer detection at a repeat biopsy. Korean J Urol. 2015;56(12):796-802 doi: 10.4111/kju.2015.56.12.796.

15. Patel P, Nayak J, Biljetina Z, Donnelly B, Trpkov K. Prostate cancer after initial high-grade prostatic intraepithelial neoplasiaand benign prostate biopsy. Can J Urol. 2015;22(6):8056-62. PMID:26688133.

Author Biography

M. P. Melnychuk, Scientific-Practical Centre of Prophylactic and Clinical Medicine, Kyiv

Maksym P. Melnychuk, PhD,

Research and practical center of preventive and clinical medicine

Address: 5, Verhnia St., Kyiv, Ukraine, 01014,

Tel./fax +380442848453


How to Cite
Melnychuk, M. P. (2018). Peculiarities of secondary biopsy in patients with prostatic intraepithelial neoplasia. Klinicheskaia Khirurgiia, 85(11), 68-70.
General Problems of Surgery