Utilidad de cortes seriados en biopsias prostáticas

Abstract

IntroductionWith the routine use of prostate specific antigen, focal carcinomas and atypical small acini proliferation (ASAP) are currently detected more frequently. The number of sections per cylinder needed to detect most of them is still unknown. MethodsWe reviewed 250 sextant prostate biopsies in the 2008-2011 period. The average number of cylinders per biopsy was 14. In each case, in addition to the original sections with three histological levels, three more sections were performed with three levels (total: 12 levels). Biopsies with focal lesion were analyzed immunohistochemically. The frequency of focal lesions was compared to a previous study of 1000 biopsies in which a single section was made with three histological levels. The main clinical and laboratory data were recorded. ResultsThere were 16 focal lesions (6.4%). Seven (2.8%) corresponded to focal carcinomas and nine (3.6%) to atypical proliferation. In the previous study, thirteen (1.3%) focal carcinomas and 29 (2.9%) cases with atypical proliferation were found. ConclusionsThere was an increase of 4.2% to 6.4% of focal lesions carcinomas increased from 1.3% to 2.8%. Making additional sections in all biopsies may have practical drawbacks. However, they could be performed in patients with high clinical suspicion of carcinoma (especially in young patients), or when there is a history of atypical glandular proliferations consistent with carcinoma in previous biopsies.