High-grade prostatic intraepithelial neoplasia (HGPIN) carries a high predictive value for future diagnosis of prostate cancer.
Research published in the open access journal BMC Urology has shown that 41.8% of patients whose extended core biopsy led to an initial diagnosis of HGPIN were subsequently diagnosed with prostate cancer.
Paras Singh and Francis Martin, from Lancashire Teaching Hospitals NHS Foundation Trust and Lancaster University, along with their co-workers, conducted a retrospective analysis of the institution’s pathology database, investigating the occurrence of prostate cancer in patients initially diagnosed with HGPIN. They also calculated the risk of developing prostate cancer based on initial levels of PSA. They said, “Of 2,192 biopsied patients, there were 88 cases of isolated HGPIN of which 67 patients underwent one or more repeat biopsies. In this repeat-biopsy group, 28 prostate cancer diagnoses were made. Age at first biopsy, higher baseline PSA and higher change in PSA were all predictive of cancer detection on repeat biopsies”.
There has been speculation that an initial diagnosis of HGPIN may not be a useful indicator of the future risk of prostate cancer. The authors acknowledge that the 41.8% risk they identified is higher than that found by most contemporary studies, but point out that it is comparable to an earlier US-based study from when there was lower level of PSA screening, perhaps similar to the current situation in the UK.
The researchers conclude, “HGPIN carries a high predictive value for future diagnosis of prostate cancer. Based on our results, we recommend delaying the first repeat biopsy at low PSA range but to have a shorter interval to repeat biopsies at intermediate and higher PSA ranges”.
Notes to Editors
1. Risk of prostate cancer after detection of isolated high-grade prostatic intraepithelial neoplasia (HGPIN) on extended core needle biopsy: a UK hospital experience
Paras B Singh, Caroline M Nicholson, Narasimhan Ragavan, Rosemary A Blades, Francis L Martin and Shyam S Matanhelia
BMC Urology (in press)
During embargo, article available here: http://www.biomedcentral.com/imedia/1761119029239237_article.pdf?random=881718
After the embargo, article available at the journal website: http://www.biomedcentral.com/bmcurol/
Please name the journal in any story you write. If you are writing for the web, please link to the article. All articles are available free of charge, according to BioMed Central’s open access policy.
Article citation and URL available on request at [email protected] on the day of publication.
2. BMC Urology is an open access journal publishing original peer-reviewed research articles in all aspects of the prevention, diagnosis and management of urological disorders, as well as related molecular genetics, pathophysiology, and epidemiology. BMC Urology (ISSN 1471-2490) is indexed/tracked/covered by PubMed, MEDLINE, CAS, Scopus, EMBASE and Google Scholar.
3. BioMed Central (http://www.biomedcentral.com/) is an STM (Science, Technology and Medicine) publisher which has pioneered the open access publishing model. All peer-reviewed research articles published by BioMed Central are made immediately and freely accessible online, and are licensed to allow redistribution and reuse. BioMed Central is part of Springer Science+Business Media, a leading global publisher in the STM sector.