title: Clinical significance of proliferative inflammatory atrophy in prostate biopsy.
abstract: BACKGROUND
  Proliferative inflammatory atrophy (PIA) is a frequently observed lesion in prostate biopsies and some authors have postulated its involvement in prostate carcinogenesis. However, the mechanisms that would permit its neoplastic transformation and the clinical significance of its finding in a prostate biopsy is currently not well known.
  
  
  OBJECTIVE
  To analyze the characteristics of the PIA lesion, its possible role in prostate carcinogenesis and its relation with the tumor aggressiveness.
  
  
  METHODS
  A systematic review was made of the literature in PubMed with the terms «proliferative inflammatory atrophy» or «PIA» and «prostate.» The most important findings are summarized in accordance with the study objective.
  
  
  RESULTS
  PIA seems to be involved in prostate carcinogenesis. This hypothesis is based on its frequent association to cancer lesions (CaP) and on some genetic alterations that are common to the high grade prostatic intraepithelial neoplasia (HGPIN) and to the CaP, fundamentally deficit in GSTP1 expression and overexpression of AGR2. Currently, there are no epidemiological studies that evaluate the incidence of PIA or its association with HGPIN and CaP. Only one study, carried out by our group, has determined the global incidence of PIA in 30% of the prostate biopsies, a lower association to CaP than the HGPIN lesion and an association between PIA and tumors of lower and insignificant grade.
  
  
  CONCLUSIONS
  PIA shares genetic alterations with HGPIN and CaP. Currently, there is no epidemiologic evidence to consider that the PIA is associated to a greater incidence of CaP and the genetic and epidemiological data available suggest its association to not very aggressive tumors.
authors.affiliation: Servicio de Urología, Hospital Vall d'Hebron, Barcelona, España; Instituto de Investigación, Hospital Vall d'Hebron, Barcelona, España. Electronic address: anacelmad@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Celma
authors.affiliation: Servicio de Urología, Hospital Vall d'Hebron, Barcelona, España; Instituto de Investigación, Hospital Vall d'Hebron, Barcelona, España.
authors.forename: P
authors.initials: P
authors.lastname: Servián
authors.affiliation: Servicio de Urología, Hospital Vall d'Hebron, Barcelona, España; Instituto de Investigación, Hospital Vall d'Hebron, Barcelona, España.
authors.forename: J
authors.initials: J
authors.lastname: Planas
authors.affiliation: Servicio de Urología, Hospital Vall d'Hebron, Barcelona, España; Instituto de Investigación, Hospital Vall d'Hebron, Barcelona, España.
authors.forename: J
authors.initials: J
authors.lastname: Placer
authors.affiliation: Instituto de Investigación, Hospital Vall d'Hebron, Barcelona, España.
authors.forename: M T
authors.initials: MT
authors.lastname: Quilez
authors.affiliation: Instituto de Investigación, Hospital Vall d'Hebron, Barcelona, España.
authors.forename: M A
authors.initials: MA
authors.lastname: Arbós
authors.affiliation: Servicio de Anatomía Patológica, Hospital Vall d'Hebron, Barcelona, España; Departamento de Cirugía, Universidad Autónoma de Barcelona, Barcelona, España.
authors.forename: I
authors.initials: I
authors.lastname: de Torres
authors.affiliation: Servicio de Urología, Hospital Vall d'Hebron, Barcelona, España; Instituto de Investigación, Hospital Vall d'Hebron, Barcelona, España; Departamento de Cirugía, Universidad Autónoma de Barcelona, Barcelona, España.
authors.forename: J
authors.initials: J
authors.lastname: Morote
mesh_terms: D001284:Atrophy; D001706:Biopsy; D006801:Humans; D007249:Inflammation / Q000209:etiology / Q000473:pathology; D008297:Male; D011467:Prostate / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000150:complications / Q000473:pathology*
keywords: Agresividad tumoral; Atrofia proliferativa inflamatoria; Cáncer de próstata; Proliferative inflammatory atrophy; Prostate cancer; Tumor aggressiveness