Mechanisms of Disease

High-grade prostatic intraepithelial neoplasia and other proposed preneoplastic lesions in the prostate

Rodolfo Montironi, Roberta Mazzucchelli, Antonio Lopez-Beltran, Liang Cheng, Marina Scarpelli

Research output: Contribution to journalArticle

61 Citations (Scopus)

Abstract

High-grade prostatic intraepithelial neoplasia (HGPIN) is the most likely precursor of prostatic adenocarcinoma according to virtually all available evidence. This lesion is characterized by cellular proliferations within pre-existing ducts and acini, with nuclear and nucleolar enlargements similar to those seen in prostate cancer, although unlike cancer HGPIN retains a basal-cell layer. The recognition of HGPIN is clinically important because of the strong association between this disease and prostatic carcinoma. The predictive value for cancer of an initial diagnosis of HGPIN on needle biopsy has substantially declined, with values falling from 36% to 21%. A major factor contributing to this decline is related to increased use of needle biopsy core sampling, which has provided the means for many cancers associated with HGPIN to be detected on initial biopsy; repeat biopsy, even with good sampling, does not detect many additional cancers. Other possible findings in the prostate might indicate premalignant disease (low-grade prostatic intraepithelial neoplasia, atrophy, malignancy-associated changes, and atypical adenomatous hyperplasia or adenosis), but the data for these premalignant diseases are much less convincing than those for HGPIN.

Original languageEnglish
Pages (from-to)321-332
Number of pages12
JournalNature Clinical Practice Urology
Volume4
Issue number6
DOIs
StatePublished - Jun 2007

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Prostatic Intraepithelial Neoplasia
Prostate
Neoplasms
Prostatic Diseases
Large-Core Needle Biopsy
Biopsy
Needle Biopsy
Atrophy
Hyperplasia
Prostatic Neoplasms
Adenocarcinoma
Cell Proliferation
Carcinoma

ASJC Scopus subject areas

  • Urology
  • Nephrology

Cite this

Mechanisms of Disease : High-grade prostatic intraepithelial neoplasia and other proposed preneoplastic lesions in the prostate. / Montironi, Rodolfo; Mazzucchelli, Roberta; Lopez-Beltran, Antonio; Cheng, Liang; Scarpelli, Marina.

In: Nature Clinical Practice Urology, Vol. 4, No. 6, 06.2007, p. 321-332.

Research output: Contribution to journalArticle

Montironi, Rodolfo ; Mazzucchelli, Roberta ; Lopez-Beltran, Antonio ; Cheng, Liang ; Scarpelli, Marina. / Mechanisms of Disease : High-grade prostatic intraepithelial neoplasia and other proposed preneoplastic lesions in the prostate. In: Nature Clinical Practice Urology. 2007 ; Vol. 4, No. 6. pp. 321-332.
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