title: Current significance of the finding of high grade prostatic intraepithelial neoplasia in the prostate biopsy.
abstract: BACKGROUND
  High grade prostatic intraepithelial neoplasia (HGPIN) is regarded as a precursor of prostate cancer (PC). However, its relationship to cancer has changed throughout the literature, being currently poorly defined and remains controversial for urologists in their clinical practice. Because of his frequency and the impact on patient outcomes that the lack of consensus clinical attitude could carry out, it seems advisable to review the understanding of this disease.
  
  
  OBJECTIVE
  The aim of this literature review is to summarize the main features of this entity (histopathology, molecular, epidemiological) and evaluate their relationship with prostate adenocarcinoma, explaining the variation of incidence seen in the literature and the clinical significance of their finding.
  
  
  METHODS
  Review of the literature, based on the research and analysis of publications found in Pubmed with the words "prostate" and "intraepithelial neoplasms".
  
  
  RESULTS
  The HGPIN detection rate has increased to the extent that it has increased the number of punctures in prostate biopsies. With the current biopsy schemes (10-12 punctures), the detection rate of PC in repeat biopsies is similar in patients with and without isolated HGPIN. However, HGPIN multifocality predicts increased risk of PC detection in repeat biopsy.
  
  
  CONCLUSIONS
  HGPIN detection is common with current biopsy schemes. Its genetic relationship with PC is clear and its multifocality is the most important predictor factor of PC.
authors: Servicio de Urología y Trasplante Renal, Hospital Vall d'Hebron, Universidad Autónoma de Barcelona, Barcelona, España. Electronic address: jmbastar@vhebron.net.
authors: J
authors: J
authors: Bastarós
authors: Servicio de Urología y Trasplante Renal, Hospital Vall d'Hebron, Universidad Autónoma de Barcelona, Barcelona, España.
authors: J
authors: J
authors: Placer
authors: Servicio de Urología y Trasplante Renal, Hospital Vall d'Hebron, Universidad Autónoma de Barcelona, Barcelona, España.
authors: A
authors: A
authors: Celma
authors: Servicio de Urología y Trasplante Renal, Hospital Vall d'Hebron, Universidad Autónoma de Barcelona, Barcelona, España.
authors: J
authors: J
authors: Planas
authors: Servicio de Urología y Trasplante Renal, Hospital Vall d'Hebron, Universidad Autónoma de Barcelona, Barcelona, España.
authors: J
authors: J
authors: Morote
mesh_terms: D001706:Biopsy; D006801:Humans; D008297:Male; D060787:Neoplasm Grading; D011467:Prostate / Q000473:pathology*; D019048:Prostatic Intraepithelial Neoplasia / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000473:pathology*
keywords: Cáncer de próstata; Neoplasia intraepitelial prostática; Oncogenesis; Oncogénesis; Prostate cancer; Prostatic intraepithelial neoplasia