The association of selected pathological features with prostate cancer in a single-needle biopsy accession

Isolated high-grade prostatic intraepithelial neoplasia (PIN) has been show n to be a positive predictor of prostate cancer (PCa) on follow-up biopsy. However, the incidence of isolated high-grade PIN in needle biopsy specimen s has been reported with a highly variable frequency of 1% to 15%. The curr ent study examined the relationship of various pathological features with P Ca on a single biopsy accession. A study population of 388 community-based consecutive needle biopsy accessions was prospectively recorded by a single pathologist (T.M.W.). All of the individual biopsy specimens were coded fo r the presence of PCa, high-grade PIN, low-grade PIN, chronic inflammation (CI), intraluminal prostatic crystalloids (IPC) in benign glands, and mucin ous metaplasia (MM). One hundred twenty-nine (33%) of the patients were dia gnosed with PCa. The 8% incidence of isolated high-grade PIN was consistent with previous studies. The incidence of other pathological features were a s follows: high-grade PIN, 14%; low-grade PIN, 13%; CI, 30%; IPC, 4%; and M M, 8%. Of the patients with high-grade MN, 41% had PCa on a separate core b iopsy, whereas 31% of patients without high-grade PIN were observed to have PCa (P = .021). Of the patients with CI, 21% were found to have PCa on a s eparate core, whereas 38% of patients without CI were found to have PCa (P = .0009). None of the other pathological features surveyed showed any signi ficant association with PCa. High-grade PIN was a relatively common finding (14%) in this study and was positively associated with PCa on a separate c ore from the same accession biopsy. The negative association of CP with PCa within the same accession has not been reported previously and may be an a rtifact related to the clinical indications for a prostatic biopsy. HUM PAT HOL 29:1536-1538. Copyright (C) 1998 by W.B. Saunders Company.