REVIEW ARTICLES   

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

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).