title: Distribution of inflammation, pre-malignant lesions, incidental carcinoma in histologically confirmed benign prostatic hyperplasia: a retrospective analysis.
abstract: OBJECTIVE
  We analyze our experience on BPH through 20 years of histopathological examinations performed by the same pathologist.
  
  
  METHODS
  We retrospectively reviewed all histopathological examinations performed from January 1979 to December 1998 in patients undergoing surgery in our urological clinic who were diagnosed with BPH. We limited our evaluation to the following variables in each BPH case analyzed: inflammatory aspects associated with BPH, presence of focal acinar atrophy, atypical adenomatous hyperplasia (AAH), prostatic intraepithelial neoplasia (PIN), incidental prostate carcinoma (IC). These histological variables were analyzed according to some clinical parameters such as age, prostate volume and serum PSA.
  
  
  RESULTS
  The study population was comprised of 3942 cases with histological diagnosis of BPH. The mean patient age was 68.85+/-7.67 years. In particular, inflammatory aspects were associated with BPH in a high percentage of cases (43.1% =1700 cases), predominantly as chronic inflammation. Observation of focal acinar atrophy significantly increased according to patient decade of age (p=0.027). There was a significant trend to increase with age decades (p=0.036) for high grade PIN. A significant difference was found in IC (T1a, T1b) distribution in the different decades of age and especially in regards to both T1a and T1b tumors, there was a trend to increase with patient age (p=0.020 and p=0.025, respectively). On the contrary, the distribution of inflammatory aspects (p<0.001) and AAH (p=0.003) significantly varied according to prostate volume, and particularly in regards to chronic inflammation, there was a trend to increase depending on the prostate volume (p=0.002). Only the presence of T1b tumor but not of the other histological parameters associated to BPH, was able to significantly influence serum PSA.
  
  
  CONCLUSIONS
  In our analysis different histological variables associated to BPH are differently influenced by the age of patients and prostate volume, and they differently influence serum PSA levels.
authors.affiliation: Department of Urology "U Bracci", University La Sapienza, V. Policlinico, 00161, Rome, Italy. sciarrajr@hotmail.com
authors.forename: Franco
authors.initials: F
authors.lastname: Di Silverio
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Gentile
authors.forename: Anna
authors.initials: A
authors.lastname: De Matteis
authors.forename: Gianna
authors.initials: G
authors.lastname: Mariotti
authors.forename: Voria
authors.initials: V
authors.lastname: Giuseppe
authors.forename: Pastore Antonio
authors.initials: PA
authors.lastname: Luigi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Sciarra
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001284:Atrophy; D014408:Biomarkers, Tumor / Q000032:analysis; D002277:Carcinoma / Q000473:pathology*; D016009:Chi-Square Distribution; D006801:Humans; D007249:Inflammation / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011230:Precancerous Conditions / Q000473:pathology*; D011467:Prostate / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000032:analysis; D011470:Prostatic Hyperplasia / Q000473:pathology*; D019048:Prostatic Intraepithelial Neoplasia / Q000473:pathology; D011471:Prostatic Neoplasms / Q000473:pathology*; D012189:Retrospective Studies; D018709:Statistics, Nonparametric
chemical_list: D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen