Institute of Pathological Anatomy, School of Medicine, Polytechnic University of the Marche Region (Ancona), United Hospitals, Ancona, Italy.
BJU Int. 2011 Nov;108(9):1394-401. doi: 10.1111/j.1464-410X.2011.010413.x. Epub 2011 Aug 26.
The aim of the present paper was to review the morphological spectrum of prostatic intraepithelial neoplasia (PIN), its relationship to carcinoma of the prostate (PCa) and its clinical significance. We reviewed the literature on premalignant lesions of the prostate, with an emphasis on high grade prostatic intraepithelial neoplasia (HGPIN). HGPIN is the most likely precursor of PCa, according to almost all available evidence. HGPIN is characterized by cellular proliferations within pre-existing ducts and acini, with nuclear and nucleolar enlargement similar to PCa. The clinical importance of recognizing HGPIN is based on its association with PCa. In recent years, a significant decline from 36% to 22% in the predictive value of cancer after an initial diagnosis of HGPIN. A major factor contributing to the decreased incidence of cancer after a diagnosis of HGPIN on needle biopsy in the contemporary era is related to increased needle biopsy core sampling, which detects many associated cancers on initial biopsy. Some recent studies have suggested that molecular findings associated with HGPIN might be able to predict which men are more likely to have cancer on re-biopsy.
本文旨在综述前列腺上皮内瘤变（PIN）的形态学谱及其与前列腺癌（PCa）的关系及其临床意义。我们复习了前列腺癌前病变的文献，重点介绍高级别前列腺上皮内瘤变（HGPIN）。根据几乎所有现有证据，HGPIN 是 PCa 最可能的前体。HGPIN 的特征是在现有导管和腺泡内的细胞增殖，具有与 PCa 相似的核和核仁增大。认识到 HGPIN 的临床重要性是基于其与 PCa 的关联。近年来，在初始诊断为 HGPIN 后，癌症预测值从 36%显著下降到 22%。在当代，HGPIN 诊断后经针吸活检癌症发生率降低的一个主要因素与增加针吸活检核心取样有关，该方法可在初始活检时检测到许多相关的癌症。一些最近的研究表明，与 HGPIN 相关的分子发现可能能够预测哪些男性在再次活检时更有可能患有癌症。
