Precursors of prostate cancer

David G. Bostwick, Liang Cheng

Research output: Contribution to journalArticle

53 Citations (Scopus)

Abstract

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 115000 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 10years. 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.

Original languageEnglish
Pages (from-to)4-27
Number of pages24
JournalHistopathology
Volume60
Issue number1
DOIs
StatePublished - Jan 2012

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Prostatic Intraepithelial Neoplasia
Prostatic Neoplasms
Biopsy
Adenocarcinoma
Carcinoma
Neoplasms
Prostate-Specific Antigen
Androgens
Atrophy
Cell Differentiation
Ultrasonography
Carcinogenesis
Radiotherapy
Epithelium
Animal Models
Genotype
Clinical Trials
Phenotype

Keywords

  • Androgen deprivation therapy
  • Atypical small acinar proliferation
  • Biopsy
  • Prostate cancer
  • Prostatic intraepithelial neoplasia
  • Radiation therapy
  • Radical prostatectomy

ASJC Scopus subject areas

  • Histology
  • Pathology and Forensic Medicine

Cite this

Precursors of prostate cancer. / Bostwick, David G.; Cheng, Liang.

In: Histopathology, Vol. 60, No. 1, 01.2012, p. 4-27.

Research output: Contribution to journalArticle

Bostwick, David G. ; Cheng, Liang. / Precursors of prostate cancer. In: Histopathology. 2012 ; Vol. 60, No. 1. pp. 4-27.
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