Is high-grade prostatic intraepithelial neoplasia on needle biopsy different in an Asian population: A clinicopathologic study performed in Singapore

Tan, Puay Hoon; Tan, Hui Zhuan; Tan, Yen Y.; Lim, Chay Ngee; Cheng, Christopher; Epstein, Jonathan I.

doi:10.1016/j.urology.2006.04.026

Cited by 21 publications

(22 citation statements)

References 12 publications

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“…Most large studies documented a prevalence of 4% to 6% of HGPIN on needle biopsy 19–23 . In a survey of 1219 Singaporean men, the incidence of HGPIN was 4.6% 24 . The higher incidence of HGPIN in Singaporean men than our Taiwanese study may result from a mixed ethnic population in Singapore, whereas Taiwanese men are predominantly of Chinese descent.…”

Section: Discussioncontrasting

confidence: 49%

Trends in prostate needle biopsy diagnosis. A ten year experience of a medical center in Taiwan

Kuo

Lin

Chang

et al. 2012

Pathology International

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Prostate cancer has seen a rapid rise in Taiwanese men. The current study was undertaken to evaluate trends of the disease diagnosed on prostate needle biopsy during a ten-year period at the Department of Pathology, Taipei Veterans General Hospital. The study included 8236 men who underwent a total of 9995 prostate needle biopsies at this institute from 1994 to 2003. Pathologic features pertinent to diagnosis of cancer were reviewed and compared for cases diagnosed before and after 1999. There were statistically significant increases of the overall cancer detection rate (from 17.6% to 19.9%), proportion of cases with a Gleason score ≤ 6 (from 16.6% to 40.9%) and focal adenocarcinoma (from 3.0% to 12.8%) in the latter 5 years. The incidence of high-grade prostatic intraepithelial neoplasia (HGPIN) increased from 0.1% to 1.5%. Patients with HGPIN had a significantly higher risk for subsequent cancer discovered on repeat biopsy than did those with a primary benign diagnosis (29.9% versus 13.7%). Despite a relatively lower incidence of cancer and HGPIN in Taiwanese men compared with that reported in Western studies, in recent years we have found an increase of relevant diagnoses, especially cancer of limited extent and lower grade, which may represent the progress in prostate cancer diagnosis.

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Section: Discussioncontrasting

confidence: 49%

Trends in prostate needle biopsy diagnosis. A ten year experience of a medical center in Taiwan

Kuo

Lin

Chang

et al. 2012

Pathology International

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“…For example, African‐American men had a greater prevalence of PIN than whites in the 50‐ to 60‐year age group 10 . In contrast, Japanese men living in Osaka, Japan, had a significantly lower incidence of PIN than men residing in the United States, and Asians had the lowest clinically detected rate of prostate cancer 10,11 . Interestingly, Japanese men with PIN were at increased risk of prostate cancer compared to those without PIN, suggesting that this histopathologic finding is also a precursor in Asian men 12 .…”

Section: Incidence and Prevalence Of Pinmentioning

confidence: 99%

Precursors of prostate cancer

Bostwick

Liu

2011

Histopathology

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High-grade prostatic intraepithelial neoplasia (PIN) is the only accepted precursor of prostatic adenocarcinoma, according to numerous studies of animal models and man; other proposed precursors include atrophy and malignancy-associated changes (with no morphologic changes). PIN is characterized by progressive abnormalities of phenotype and genotype that are intermediate between benign prostatic epithelium and cancer, indicating impairment of cell differentiation and regulatory control with advancing stages of prostatic carcinogenesis. The only method of detection of PIN is biopsy because it does not significantly elevate serum prostate-specific antigen concentration and cannot be detected by ultrasonography. The mean incidence of PIN in biopsies is 9% (range, 4%-16%), representing about 115,000 new cases of isolated PIN diagnosed each year in the United States. The clinical importance of PIN is its high predictive value as a marker for adenocarcinoma, and its identification warrants repeat biopsy for concurrent or subsequent carcinoma, especially when multifocal or observed in association with atypical small acinar proliferation (ASAP). Carcinoma develops in most patients with PIN within 10 years. Androgen deprivation therapy and radiation therapy decrease the prevalence and extent of PIN, suggesting that these forms of treatment may play a role in prevention of subsequent cancer. Multiple clinical trials to date of men with PIN have had modest success in delaying or preventing subsequent cancer.

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“…Although the natural history of high-grade prostatic intraepithelial neoplasia (HGPIN) is not completely understood, it is considered by many to be a premalignant lesion (4). The frequency of HGPIN (5, 6) and the autopsy prevalence of prostate cancer (7) are similar in populations with widely differing prostate cancer incidence and mortality rates, suggesting an environmental influence on the expression of this disease and the possibility of preventing it through pharmacological means (8–10). The 5-alpha-reductase inhibitors, finasteride and dutasteride, which block the conversion of testosterone to dihydrotestosterone, have been evaluated for PCa chemoprevention in large, phase III chemoprevention trials (11–13).…”

Section: Introductionmentioning

confidence: 99%

Randomized, Placebo-Controlled Trial of Green Tea Catechins for Prostate Cancer Prevention

Kumar

Pow‐Sang

Egan

et al. 2015

Cancer Prevention Research

108

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Preclinical, epidemiological and prior clinical trial data suggest that green tea catechins (GTCs) may reduce prostate cancer (PCa) risk. We conducted a placebo-controlled, randomized clinical trial of Polyphenon E® (PolyE), a proprietary mixture of GTCs, containing 400 mg (–)-epigallocatechin-3-gallate (EGCG) per day, in 97 men with high-grade prostatic intraepithelial neoplasia (HGPIN) and/or atypical small acinar proliferation (ASAP). The primary study endpoint was a comparison of the cumulative one-year PCa rates on the two study arms. No differences in the number of PCa cases were observed: 5/49 (PolyE) versus 9/48 (placebo), P=0.25. A secondary endpoint comparing the cumulative rate of PCa plus ASAP among men with HGPIN without ASAP at baseline, revealed a decrease in this composite endpoint: 3/26 (PolyE) versus 10/25 (placebo), P<0.024. This finding was driven by a decrease in ASAP diagnoses on the Poly E (0/26) compared to the placebo arm (5/25). A decrease in serum prostate specific antigen (PSA) was observed on the PolyE arm [−0.87 ng/ml (95%CI: −1.66, −0.09)]. Adverse events related to the study agent did not significantly differ between the two study groups. Daily intake of a standardized, decaffeinated catechin mixture containing 400 mg EGCG per day for 1 year accumulated in plasma and was well tolerated but did not reduce the likelihood of PCa in men with baseline HGPIN or ASAP.

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Is high-grade prostatic intraepithelial neoplasia on needle biopsy different in an Asian population: A clinicopathologic study performed in Singapore

Cited by 21 publications

References 12 publications

Trends in prostate needle biopsy diagnosis. A ten year experience of a medical center in Taiwan

Trends in prostate needle biopsy diagnosis. A ten year experience of a medical center in Taiwan

Precursors of prostate cancer

Randomized, Placebo-Controlled Trial of Green Tea Catechins for Prostate Cancer Prevention

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