Prostatic Intraepithelial Neoplasia IDs Lethal Cancer

Atrophy, inflammation not significantly associated, but suggested link for chronic inflammation

WEDNESDAY, Sept. 28 (HealthDay News) -- Prostatic intraepithelial neoplasia (PIN) is prognostic of lethal prostate cancer (PCa), according to a study published online Sept. 27 in Cancer Epidemiology, Biomarkers & Prevention.

Sabina Davidsson, from the Örebro University Hospital in Sweden, and colleagues investigated whether chronic inflammation, focal prostatic atrophy, and PIN were predictors of lethal PCa. Men diagnosed with stage T1a-b PCa through transurethral resection of the prostate were categorized into two groups: 228 men who died of PCa and 387 controls who survived more than 10 years after PCa diagnosis without metastases. PIN, inflammation, Gleason grade, and four subtypes of focal prostatic atrophy (simple atrophy [SA], partial atrophy, post-atrophic hyperplasia [PAH], and simple atrophy with cyst formation) were assessed. The odds of lethal PCa were estimated by multivariate logistic regression.

The investigators identified chronic inflammation and PIN more frequently in tumors with PAH, but not with SA. Neither inflammation nor any specific type of atrophy correlated significantly with lethal PCa overall, but there was a suggestion of a positive correlation for chronic inflammation. Men with PIN were 89 percent more likely to die of PCa, irrespective of age, Gleason score, year of diagnosis, inflammation, and atrophy type.

"PIN, and perhaps presence of moderate or severe chronic inflammation, may have prognostic significance for PCa," the authors write.

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