Rekhi B, Jaswal T S, Arora B
Institute of Pathology-ICMR, Safdarjung Hospital, New Delhi-110 029, India.
Indian J Cancer. 2004 Apr-Jun;41(2):60-5.
A relatively new development in the arena of prostatic histopathological study is the premalignant proliferative changes in the glandular epithelium, possibly relating to carcinoma. Two major categories have come up, namely prostatic intraepithelial neoplasia (PIN) and atypical adenomatous hyperplasia (AAH).
The aims of present study were to identify foci of the two putative premalignant conditions viz. PIN and AAH in ducto-acinar lining epithelia of 200 prostatectomy specimens and their association with nodular hyperplasia and adenocarcinoma prostate.
Micro sections from 200 prostatectomy specimens, received in the Department of Pathology, PGIMS, Rohtak, were extensively studied for the presence and association of premalignant conditions. Significant values were obtained by employing Chi-square (chi2) test, with P value < 0.05 as significant.
Out of 177 cases of nodular hyperplasia, 53 (29.9%) showed PIN and 38 (20.3%) showed presence of AAH. All 6 cases (100%) of pure carcinoma revealed foci of PIN. Out of the remaining 23 cases of carcinoma with nodular hyperplasia, foci of PIN were observed in 16 cases (94.1%) and AAH in 2 cases (11.7%). High-grade PIN was observed in 20 cases (86.9%) of the total 23 cases of carcinoma, with/without nodular hyperplasia and 20 cases (11.2%) of nodular hyperplasia. Low-grade PIN was observed in 33 cases (18.6%) of nodular hyperplasia and in only 1 case (5.8%) of carcinoma prostate with nodular hyperplasia.
PIN, especially high-grade type was the most commonly observed premalignant lesion, in cases of adenocarcinoma, thereby suggesting it to be the likely precursor of carcinoma prostate. AAH showed a weaker association with carcinoma.
前列腺组织病理学研究领域中一个相对较新的进展是腺上皮的癌前增殖性改变，可能与癌有关。出现了两大类，即前列腺上皮内瘤变（PIN）和非典型腺瘤样增生（AAH）。
本研究的目的是在200例前列腺切除标本的导管 - 腺泡衬里上皮中识别这两种假定的癌前病变即PIN和AAH的病灶，以及它们与结节性增生和前列腺腺癌的关联。
对接收于Rohtak的PGIMS病理学系的200例前列腺切除标本的显微切片进行广泛研究，以确定癌前病变的存在及其关联。采用卡方（χ²）检验获得显著值，P值<0.05为显著。
在177例结节性增生病例中，53例（29.9%）显示PIN，38例（20.3%）显示存在AAH。所有6例（100%）纯癌病例均显示PIN病灶。在其余23例伴有结节性增生的癌病例中，16例（94.1%）观察到PIN病灶，2例（11.7%）观察到AAH病灶。在总共23例有/无结节性增生的癌病例中，20例（86.9%）观察到高级别PIN，在20例（11.2%）结节性增生病例中也观察到高级别PIN。在33例（18.6%）结节性增生病例以及仅1例（5.8%）伴有结节性增生的前列腺癌病例中观察到低级别PIN。
PIN，尤其是高级别类型，是腺癌病例中最常观察到的癌前病变，因此提示它可能是前列腺癌的前体。AAH与癌的关联较弱。
