Do prostate specific antigen and prostate specific antigen density enhance the detection of prostate carcinoma after initial diagnosis of prostatic intraepithelial neoplasia without concurrent carcinoma?

We believe that to make a definitive diagnosis of isolated PIN without carcinoma, study of the whole prostate gland is necessary, in order to definitively exclude the presence of concurrent neoplastic foci. Our data show that PIN does not contribute to tPSA levels and density; however, it may be responsible for a slight reduction in the f/t PSA ratio, with a significant reduction in cases with high-grade PIN (17.6%) compared to those with BPH (24.2%).

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“…However, can we predict the occurrence of underlying or subsequent cancer during follow-up in these patients? (14,15).…”

mentioning

confidence: 99%

Production of Serum-free and Total Prostate-specific Antigen Due to Prostatic Intraepithelial Neoplasia

Minardi

Galosi

Dell’Atti

et al. 2002

Scandinavian Journal of Urology and Nephrology

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“…High‐grade PIN, patient age, and serum PSA concentration were all highly significant predictors of cancer, but high‐grade PIN alone increased the risk 15‐fold more than those without PIN and provides the highest risk ratio. Others have reported a high‐predictive value of high‐grade PIN for cancer, ranging from 38‐100% 43–51. Approximately 50% of men with high‐grade PIN on biopsy will be found to have carcinoma on repeat biopsy within 2 years of follow‐up.…”

Section: High‐grade Prostatic Intraepithelial Neoplasiamentioning

confidence: 99%

Precancerous Lesions and Conditions of the Prostate

Montironi

Mazzucchelli

Scarpelli

2002

Annals of the New York Academy of Sciences

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Prostatic intraepithelial neoplasia (PIN) is composed of dysplastic cells with a luminal cell phenotype, expressing the androgen receptor as well as prostate‐specific antigen. PIN is characterized by progressive abnormalities of phenotype that are intermediate between normal prostatic epithelium and cancer, indicating impairment of cell differentiation and regulatory control with advancing stages of carcinogenesis. High‐grade PIN is considered the most likely precursor of prostatic carcinoma, according to virtually all available evidence. Androgen deprivation decreases the prevalence and extent of PIN and the degree of capillary vascularization (e.g., angiogenesis) in the surrounding stroma via suppression of vascular endothelial growth factor production. Prostatic carcinoma is also likely to arise from precursor lesions other than high‐grade PIN such as low‐grade PIN, atypical adenomatous hyperplasia, malignancy‐associated foci, and atrophy.

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“…Others have reported a high predictive value of PIN for cancer, ranging from 38% to 100%. [88][89][90][91][92][93][94][95][96] Approximately 50% of men with high grade PIN on biopsy will be found to have carcinoma on repeat biopsy within two years of follow up. These data underscore the strong association of high grade PIN and adenocarcinoma, and indicate that diagnostic follow up is needed.…”

Section: Effect Of Androgen Deprivation On Pinmentioning

confidence: 99%

Morphological identification of the patterns of prostatic intraepithelial neoplasia and their importance

Montironi

2000

Journal of Clinical Pathology

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High grade prostatic intraepithelial neoplasia (PIN) is the most likely precursor of prostatic carcinoma. PIN has a high predictive value as a marker for carcinoma, and its identification in biopsy specimens warrants repeat biopsy for concurrent or subsequent carcinoma. The only methods of detection are biopsy and transurethral resection; PIN does not greatly raise the concentration of serum prostate specific antigen (PSA) or its derivatives, does not induce a palpable mass, and cannot be detected by ultrasound. Androgen deprivation decreases the prevalence and extent of PIN, suggesting that this form of treatment might play a role in chemoprevention. Radiotherapy is also associated with a decreased incidence of PIN. (J Clin Pathol 2000;53:655-665)

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Do prostate specific antigen and prostate specific antigen density enhance the detection of prostate carcinoma after initial diagnosis of prostatic intraepithelial neoplasia without concurrent carcinoma?

Cited by 3 publications

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Production of Serum-free and Total Prostate-specific Antigen Due to Prostatic Intraepithelial Neoplasia

Production of Serum-free and Total Prostate-specific Antigen Due to Prostatic Intraepithelial Neoplasia

Precancerous Lesions and Conditions of the Prostate

Morphological identification of the patterns of prostatic intraepithelial neoplasia and their importance

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