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Panminerva Medica 2002 September;44(3):213-20

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

Prostatic intraepithelial neoplasia and prostate cancer

Montironi R., Santinelli A., Mazzucchelli R.

Department of Pathology and Laboratory University of Ancona School of Medicine Torrette di Ancona, Ancona, Italy


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Prostatic intra­ep­i­the­lial neo­pla­sia (PIN) is com­posed of dys­plas­tic ­cells ­with a lumi­nal ­cell phe­no­type, express­ing the andro­gen recep­tor as ­well as pros­tate spe­cif­ic anti­gen. PIN is char­ac­ter­ized by pro­gres­sive abnor­mal­ities of phe­no­type ­which are inter­me­di­ate ­between nor­mal pros­tat­ic epi­the­li­um (NP) and can­cer, indi­cat­ing impair­ment of ­cell dif­fe­ren­ti­a­tion and reg­u­la­to­ry con­trol ­with advanc­ing stag­es of car­cin­o­gen­e­sis. High-­grade PIN is con­sid­ered the ­most like­ly pre­cur­sor of pros­tat­ic car­ci­no­ma (PCa), accord­ing to vir­tu­al­ly all avail­able evi­dence. Androgen dep­ri­va­tion decreas­es the prev­a­lence and ­extent of PIN and the ­degree of cap­il­lary vas­cu­lar­iza­tion (e.g., angio­gen­e­sis) in the sur­round­ing stro­ma via the sup­pres­sion of vas­cu­lar endo­the­lial ­growth fac­tor (­VEGF) pro­duc­tion. It is like­ly ­that PCa ­might ­also ­arise ­from pre­cur­sor ­lesions oth­er ­than ­high-­grade PIN (low-­grade PIN, atyp­i­cal ade­nom­a­tous hyper­pla­sia, malig­nan­cy-asso­ciat­ed ­foci, and atro­phy).

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