Clinically significant and insignificant prostate cancer following prostate intraepithelial neoplasia.

OBJECTIVE

Aim: To investigate the rate of clinical significant and insignificant Prostate Cancer (PC) in patients with initial high grade and low grade Prostatic Intraepithelial Neoplasia (PIN).

PATIENTS AND

METHODS

Materials and

Methods

The study included 286 patients with PIN, 152 patients with HGPIN and 134 patients with LGPIN. During 3 year follow-up prostate rebiopsies with 6 months interval were performed. Each PC case was assessed in relation to its clinical significance according to such Epstein criteria as PSA density < 0,15, Gleason score < 7, number of cores positive for tumour < 3, no more than 50% involvement by tumour in every single core.

RESULTS

Results

During 3-year follow-up in 75 (26,2%) of 286 patients with PIN was detected PC (64 (42,1%) patients with HGPIN and in 11 (8,2%) patients with LGPIN). General estimation of clinical insignificant PC cases that were detected in patients with prior PIN amounted 12 (16%) patients. The majority of patients, namely 63 (84%) had clinical significant PC. Among 11 PC cases in patients with LGPIN 4 (36,4%) cases were insignificant. The rate of insignificant PC in HGPIN was 8 (12,5%). Statistically valid difference between HGPIN and LGPIN in rate of insignificant PC, that was 23,9% was determined.

CONCLUSION

Conclusions

PIN is a cancer precursor that progresses into PC in 26,2% of cases during 3-year follow-up. The rate of clinically insignificant PC in patients with PIN was in 23,9% more in patients witn LGPIN than in patients with HGPIN.