Prevalence of prostatic intra-epithelial neoplasia (PIN) in biopsies from hospital practice and pilot screening: clinical implications

Abstract

and 5 UCL Hospitals Trust and UCL, LondonAs high grade PIN is commonly associated with concomitant cancer, current literature recommends re-biopsy of patients with high grade PIN. This paper describes the prevalence of high grade prostatic intra-epithelial neoplasia (PIN) from three independent clinical settings, reported by a single pathologist (MCP). High grade PIN was diagnosed in biopsies from 131 of the 1205 (11%) of patients in whom cancer was suspected in hospital practice, 42 of the 202 (20%) asymptomatic men screened for prostate cancer and 29 of the 118 (25%) patients presenting with prostatism in a case ®nding study.Re-biopsy on this scale has major clinical and cost implications. However, from a literature review, there is evidence to suggest that the risk of concomitant cancer with high grade PIN may be strati®ed according to serum PSA. This opinion should be tested prospectively.

High‐Grade Prostatic Intraepithelial Neoplasia (HGPIN) and topographical distribution in 1,374 prostatectomy specimens: Existence of HGPIN near prostate cancer

“…HGPIN represents a highly predictive marker for PCa. Interestingly, our study showed that the HGPIN frequencies in the investigated regions with PCa (0–4.4%) were comparable to the rates of isolated HGPIN in PBx studies with a similar number of patients (0.8–4.8%) 14–17. The frequency of PCa in the focused regions containing HGPIN (0–55.6%) was similar to the detection rate for PCa in previous studies using rPBx (17.6–58%) 7, 18–20.…”

Immunophenotypic Characterization of Benign and Malignant Prostatic Lesions

“…We found PIN associated with 16% of prostate cancers (majority high grade) and only 4% of NHP (low grade). Fenely et al [21], observed PIN in 11% cases in hospital practice, 20% in prostate cancer screening and 25% in urology practice. Our study supports the notion that low grade PIN occurs with NHP and can be ignored, whereas high grade PIN signifies coexistence with, or subsequent development of carcinoma.…”

Human prostate cancer risk factors

“…It is a frequent finding in needle biopsies and is present in up to 25% of men 35, 36. The incidence varies according to the patient population and is higher in urology office practices than in screening populations 44. For example, Feneley et al reported an incidence of PIN of 11% in hospital practice, 20% in men who were screened with PSA for prostate cancer, and 25% at case‐finding in a urology practice.…”