Hu J C, Palapattu G S, Kattan M W, Scardino P T, Wheeler T M
Department of Pathology, The Methodist Hospital, the Matsunaga-Conte Prostate Cancer Research Center, Baylor College of Medicine, Houston, TX 77030-2707, USA.
Hum Pathol. 1998 Dec;29(12):1536-8. doi: 10.1016/s0046-8177(98)90027-2.
Isolated high-grade prostatic intraepithelial neoplasia (PIN) has been shown to be a positive predictor of prostate cancer (PCa) on follow-up biopsy. However, the incidence of isolated high-grade PIN in needle biopsy specimens has been reported with a highly variable frequency of 1% to 15%. The current study examined the relationship of various pathological features with PCa on a single biopsy accession. A study population of 388 community-based consecutive needle biopsy accessions was prospectively recorded by a single pathologist (T.M.W.). All of the individual biopsy specimens were coded for the presence of PCa, high-grade PIN, low-grade PIN, chronic inflammation (CI), intraluminal prostatic crystalloids (IPC) in benign glands, and mucinous metaplasia (MM). One hundred twenty-nine (33%) of the patients were diagnosed with PCa. The 8% incidence of isolated high-grade PIN was consistent with previous studies. The incidence of other pathological features were as follows: high-grade PIN, 14%; low-grade PIN, 13%; CI, 30%; IPC, 4%; and MM, 8%. Of the patients with high-grade PIN, 47% had PCa on a separate core biopsy, whereas 31% of patients without high-grade PIN were observed to have PCa (P=.021). Of the patients with CI, 21% were found to have PCa on a separate core, whereas 38% of patients without CI were found to have PCa (P=.0009). None of the other pathological features surveyed showed any significant association with PCa. High-grade PIN was a relatively common finding (14%) in this study and was positively associated with PCa on a separate core from the same accession biopsy. The negative association of CP with PCa within the same accession has not been reported previously and may be an artifact related to the clinical indications for a prostatic biopsy.
孤立性高级别前列腺上皮内瘤变（PIN）已被证明是随访活检中前列腺癌（PCa）的阳性预测指标。然而，针吸活检标本中孤立性高级别PIN的发生率报道差异很大，为1%至15%。本研究在一次活检样本中检查了各种病理特征与PCa的关系。由一名病理学家（T.M.W.）前瞻性记录了388例基于社区的连续针吸活检样本的研究人群。所有个体活检标本都针对PCa、高级别PIN、低级别PIN、慢性炎症（CI）、良性腺体中的管腔内前列腺晶体（IPC）和黏液化生（MM）的存在进行编码。129例（33%）患者被诊断为PCa。孤立性高级别PIN的8%发生率与先前研究一致。其他病理特征的发生率如下：高级别PIN，14%；低级别PIN，13%；CI，30%；IPC，4%；MM，8%。在高级别PIN患者中，47%在单独的核心活检中患有PCa，而在无高级别PIN的患者中，31%被观察到患有PCa（P = 0.021）。在患有CI的患者中，21%在单独的核心活检中被发现患有PCa，而在无CI的患者中，38%被发现患有PCa（P = 0.0009）。所调查的其他病理特征均未显示与PCa有任何显著关联。高级别PIN在本研究中是一个相对常见的发现（14%），并且在同一次活检样本的单独核心中与PCa呈正相关。CI与同一次活检样本中的PCa的负相关以前尚未报道，可能是与前列腺活检的临床指征相关的一种假象。
