The significance of prostatic intra-epithelial neoplasia.
The significance of prostatic intra-epithelial neoplasia.
复制标题
前列腺上皮内瘤变的意义。
DOI：
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发表时间：
1995
期刊：
影响因子：
--
通讯作者：
Peter R. Carroll
中科院分区：
文献类型：
--
作者：
S. Aboseif;K. Shinohara;N. Weidner;P. Narayan;Peter R. Carroll
目标
目的探讨初次前列腺活检中检出前列腺上皮内瘤变 (PIN) 与随后的侵袭性前列腺腺癌之间的关系。
患者和方法
36 名患有 PIN 的男性（平均年龄 67 岁，范围 52-82 岁）在初次活检和记录 PIN 之前接受了直肠指检 (DRE)、血清前列腺特异性抗原 (PSA) 测量和经直肠超声检查 (TRUS)。他们通过一系列 PSA、TRUS 进行随访，并每 6 个月重复进行一次活检，直到发现浸润性癌或 2 年过去。
结果
初次活检显示，33% 的男性为 I 级 PIN，22% 为 II 级，45% 为 III 级。重复活检显示 21 名患者（58%；第一组）有浸润性癌证据，而 15 名患者（42%）显示 PIN 持续存在（第二组）。在第一组中，有 19 名患者在初次活检时出现高级别 PIN（II/III 级），而第二组中只有 1 名患者出现这种情况。 DRE 和年龄的结果在各组之间没有显着差异。 TRUS 显示第一组 15/21 名患者存在低回声病变，而第二组为 7/15 名患者。第一组中有 18 名患者的 PSA 水平有所增加（从 8.4 ng/mL 升至 11.6 ng/mL）。
结论
PIN 与前列腺浸润性腺癌密切相关，高级别 PIN、PSA 水平升高或 TRUS 阳性结果的患者共存的可能性更高。我们建议对所有在前列腺活检中显示高级别 PIN 的患者进行密切随访，进行系列 PSA 测量，并从 PIN 区域和前列腺其他区域重复进行活检。
OBJECTIVE
To investigate the relationship between the detection of prostatic intra-epithelial neoplasia (PIN) on initial prostate biopsy and subsequent invasive prostatic adenocarcinoma.
PATIENTS AND METHODS
Thirty-six men (mean age 67 years, range 52-82) with PIN underwent digital rectal examination (DRE), serum prostate-specific antigen (PSA) measurement and transrectal ultrasonography (TRUS) before the initial biopsy and documentation of PIN. They were followed up with serial PSA, TRUS and a repeat biopsy every 6 months until either invasive carcinoma was identified or 2 years had elapsed.
RESULTS
The initial biopsy revealed Grade I PIN in 33%, Grade II in 22%, and Grade III in 45% of the men. The repeat biopsy showed evidence of invasive carcinoma in 21 patients (58%; Group I), while 15 (42%) showed persistence of PIN (Group II). In Group I, 19 had had high-grade PIN (Grade II/III) on initial biopsy compared with one in Group II. The findings on DRE, and age, were no significantly different between groups. TRUS revealed a hypoechoic lesion in 15/21 patients in Group I compared with 7/15 patients in Group II. There was an increase in PSA level in 18 patients in Group I (from 8.4 to 11.6 ng/mL).
CONCLUSIONS
PIN and invasive adenocarcinoma of the prostate were closely associated, and the likelihood for coexistence was higher in patients with high-grade PIN, increasing PSA level or positive findings on TRUS. We recommend that all patients who show high-grade PIN on prostate biopsy be followed very closely with serial PSA measurements and repeat biopsies from both the area of PIN and other areas of the prostate.
非典型前列腺增生的泌尿学评估。
影响因子：
2.1
作者：
Garnett,JE;Oyasu,R
通讯作者：
Oyasu,R