Atrophy in specimens of radical prostatectomy: is there topographic relation to high-grade prostatic intraepithelial neoplasia or cancer?
BACKGROUND
It is controversial whether there is any relationship of proliferative inflammatory atrophy (PIA) to high-grade prostatic intraepithelial neoplasia (HGPIN) and cancer (CA). It has been suggested a topographic relation and a potential of the proliferative epithelium in PIA to progress to HGPIN and/or CA. The aim of this study was to analyze in radical prostatectomies a possible topographic relation of the lesions.


METHODS
A total of 3,186 quadrants from 100 whole-mount consecutive surgical specimens were examined. The frequency of quadrants showing: only PIA, PIA+CA, PIA+HGPIN, or PIA+HGPIN+CA was determined. Extent and distance between the lesions were evaluated by a semiquantitative point-count method previously described. We also studied foci with partial or complete atrophy without inflammation. The statistical methods included the Kruskal-Wallis and the Mann-Whitney tests and the Spearman correlation coefficient.


RESULTS
The mean (range) of quadrants showing only PIA, PIA+CA, PIA+HGPIN, and PIA+HGPIN+CA was 3.29 (0-21), 2.51 (0-11), 0.77 (0-6), and 0.44 (0-4), respectively (P < 0.01). Most of the foci of PIA were significantly located in a distance >5 than <5 mm from HGPIN or CA. There was no significant correlation between extent of PIA (P = 0.64, r = 0.05) with extent of HGPIN. There was a significant negative correlation of extent of PIA (P = 0.01, r = -0.27) with extent of CA. Similar results were found considering foci either with or without inflammation. Chronic inespecific inflammation was not seen in foci of partial atrophy.


CONCLUSIONS
A topographic relation of PIA to HGPIN and/or CA was not supported by our study.
Brasil
Antonio A
AA
School of Medicine, State University of Campinas, Campinas, Brazil.
Favaro
Wagner J
WJ
Cagnon
Valeria H
VH
Ferreira
Ubirajara
U
Billis
Athanase
A
D000368:Aged; D001284:Atrophy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000473:pathology*; D011468:Prostatectomy / Q000379:methods; D019048:Prostatic Intraepithelial Neoplasia / Q000473:pathology* / Q000601:surgery*; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery*