Development of prostate cancer risk in patients with chronic prostate inflammation and wHGPIN during puncture rebiopsy / 实用肿瘤学杂志

Objective The objective of this study was to investigate a risk of prostate cancer(PCa) at a repeat biopsy in patients with chronic prostate inflammation and widespread high grade prostatic intra epithelial neoplasia(wHGPIN).Methods From July 2006 to December 2014,172 cases of prostate biopsy were collected.All of them were diagnosed as HGPIN for the first biopsy,punctured by transrectal ultrasound for 12 points.After the first puncture for 6 months,patients were punctured for rebiopsy.Multi-focal wHGPIN was defined as a high -grade prostate intraepithelial neoplasia with 2 or more cores detection in a prostate biopsy.Isolated HGPIN was defined as a high-grade prostate intraepithelial neoplasia with only one core detection in a prostate biopsy.Results Seventy-two patients with HGPIN were isolated from primary HGPIN,102 patients with isolated HGPIN,17 patients with chronic prostatitis,70 with multifocal HGPIN and 54 with chronic prostatitis.Forth-eight of 172 patients initial diagnosis of HGPIN was diagnosed as PCa at rebiopsy.The detection rate of wHGPIN was 52.86％ (37/70)and isolated HGPIN for 10.88％ (11/102).They showed a statistically difference between two groups(P ＜0.001).The detection rate of PCa in HGPIN patients with chronic prostatitis was higher than that in patients without chronic prostatitis(P =0.011).Chronic prostatitis and multifocal wHGPIN were a risk factor for prostate cancer independent by rebiopsy,confirmed by the logistic regression model.Conclusion Rebiopsy is a high risk factor of prostate adenocarcinoma for patients with chronic prostatitis and multifocal HGPIN initially diagnosed by the first biopsy.Therefore,these patients are recommended under ultrasound induced by rectal prostate rebiopsy.

Study of High Grade Prostatic Intraepithelial Neoplasia for a Period of Five Years

A relatively new development in the arena of prostatic histopathological study is the premalignant proliferative high grade prostatic intraepithelial neoplasia (HGPIN) in the glandular epithelium, possibly relating to carcinoma. Aim of the study is HGPIN and its association with Prostatic hyperplasia and Prostatic carcinoma. The present study was undertaken in the Upgraded Department of Pathology, King George Hospital, Andhra Medical College for a period of five years from January 2002 to December 2006. A total of 340 cases evaluated, 277 (81.47%) were benign, 11 (3.23%) were premalignant and 52 (15.29%) malignant lesions. Premalignant lesions were preceded by a decade as compare to malignant lesions, with a mean age of 8 years difference. Among premalignant lesions only high grade prostatic intraepithelial lesion is seen in association with prostatic carcinoma (40%).

High-Grade Prostatic Intraepithelial Neoplasia

High-grade prostatic intraepithelial neoplasia (HGPIN) has been established as a precursor to prostatic adenocarcinoma. HGPIN shares many morphological, genetic, and molecular signatures with prostate cancer. Its predictive value for the development of future adenocarcinoma during the prostate-specific antigen screening era has decreased, mostly owing to the increase in prostate biopsy cores. Nevertheless, a literature review supports that large-volume HGPIN and multiple cores of involvement at the initial biopsy should prompt a repeat biopsy of the prostate within 1 year. No treatment is recommended for HGPIN to slow its progression to cancer.