The extent and multicentricity of high-grade prostatic intraepithelial neoplasia in clinically localized prostatic adenocarcinoma
The extent and multicentricity of high-grade prostatic intraepithelial neoplasia in clinically localized prostatic adenocarcinoma
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DOI：
10.1016/s0046-8177(97)90097-6
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发表时间：
1997-02-01
期刊：
影响因子：
3.3
通讯作者：
Bostwick, DG
中科院分区：
文献类型：
--
作者：
Qian, JQ;Wollan, P;Bostwick, DG
高级别前列腺上皮内瘤变（PIN）被认为是浸润性前列腺腺癌最可能的前体，其特征在于先前存在的导管和腺体内的细胞增殖，细胞学变化类似于癌症。这种临床上重要的组织病理学病变的范围和多中心性尚未完全确定。我们试图确定PIN的范围和带状分布是否与前列腺癌有关。共对195例全固定根治性直肠癌切除术标本进行了评价。所有患者均为临床局限性癌症，无患者接受术前治疗。记录PIN的区域位置和多中心性，并根据模式（簇状、微乳头状、筛状和平坦）和与癌症的空间接近度（距离癌症小于或等于2 mm，距离癌症大于2 mm）使用网格计数法测量PIN的体积。结果与患者年龄、前列腺体积、肿瘤体积、病理分期和Gleason分级相关。在86%的病例中发现了高级别PIN，通常在每个阳性病例中具有多种PW结构模式：簇状（97%的病例），微乳头状（66%的病例），筛状（19%的病例）和平坦（21%的病例）。PIN的平均体积为1.32 cm（3）（标准误[SE]，0.10;范围，0至8.12 cm（3）），并且PIN在癌症2 mm内（平均值，1.0 cm（3））大于PIN超过癌症2 mm（平均值，0.3 cm（3））。PIN多为多中心性（64.5%），位于前列腺非移行区（63%）或全移行区（36%）。PIN的总体积与肿瘤体积呈正相关，但这种相关性仅对肿瘤2 mm内的PIN有意义。PIN的体积与年龄、病理分期和Gleason评分呈正相关;这些正相关大多数是由癌内2 mm的PIN引起的，而不是癌外大于2 mm的PIN。我们的研究结果表明，高度PIN和癌的范围和带状分布密切相关，PIN通常是多中心的。这支持PIN是癌前病变的假设。版权所有（C）1997 W.B.桑德斯公司
High-grade prostatic intraepithelial neoplasia (PIN) is considered the most likely precursor of invasive prostatic adenocarcinoma, and is characterized by cellular proliferations within preexisting ducts and glands with cytological changes mimicking cancer. The extent and multicentricity of this clinically important histopathologic lesion have not been fully defined. We sought to determine whether the extent and zonal distribution of PIN are related to prostate cancer. A total of 195 whole-mounted radical prostatectomy specimens were evaluated. All patients had clinically localized cancer, and none had received preoperative therapy. The zonal location and multicentricity of PIN were recorded, and the volume of PIN was measured using a grid-counting method according to pattern (tufting, micropapillary, cribriform, and flat) and spatial proximity to cancer (less than or equal to 2 mm from cancer, and greater than 2 mm from cancer). The results were correlated with patient age, prostate volume, cancer volume, pathological stage, and Gleason grade. High-grade PIN was identified in 86% of cases, usually with multiple architectural patterns of PW in each positive case: tufting (97% of cases), micropapillary (66% of cases), cribriform (19% of cases), and flat (21% of cases). The mean volume of PIN was 1.32 cm(3) (standard error [SE], 0.10; range, 0 to 8.12 cm(3)), and was greater for PIN within 2 mm of cancer (mean, 1.0 cm(3)) than for PIN more than 2 mm from cancer (mean, 0.3 cm(3)). PIN was usually multicentric (64.5% of cases) and located in the nontransition zone (63%) or all zones (36%) of the prostate. There was a positive correlation of total volume of PIN and volume of cancer, but this correlation was significant only for PIN within 2 mm of cancer. The volume of PIN was positively correlated with age, pathological stage, and Gleason score; most of these positive correlations were caused by PIN within 2 mm of cancer rather than that greater than 2 mm from cancer. Our results indicate that the extent and zonal distribution of high-grade PIN and carcinoma are strongly associated, and that PIN is frequently multicentric. This supports the hypothesis that PIN is a premalignant lesion. Copyright (C) 1997 by W.B. Saunders Company.