INCIDENCE AND CLINICAL SIGNIFICANCE OF HIGH GRADE PROSTATIC INTRAEPITHELIAL NEOPLASIA IN TURP SPECIFIMENS

Abstract

BACKGROUND : PIN is a well known precancerous condition of prostatic carcinoma. Transurethral resection of prostate has become the most prominent and the easiest way, to morphologically evaluate lesions of PIN. But clinicians are sometimes confused by the grading that is given in the report. So there is a need to define the diagnostic criteria and differential diagnosis of PIN using newer diagnostic techniques to assist in the better diagnosis and grading. AIMS AND OBJECTIVES: To evaluate whether the diagnostic criteria can be defined PIN and using newer techniques for PIN grading to improve the clinical management of patients with prostatic lesions. MATERIALS AND METHODS: This study will be done in the Department of Pathology MGM Hospitals, Warangal for a period of 2 years and includes consecutive cases of TURP specimens from the patients who present with obstructive symptoms as a major clinical presentation and correlated with PSA levels. INCLULSION CRITERIA: Patients who present with obstructive symptoms as a major clinical presentation. RESULTS: 1.160 cases of TURP specimens were studied out of which 53 (33.12%) cases are PIN. BPH -78 (48/74%), PC-15 (9.37%), SM-14 (8.75%) 2. Majority cases are low grade PIN 34 out of 53 cases (21.25%) High Grade PIN 19 out of 53cases. (11.87%) 3. High Grade PIN and prostatic Carcinoma shared increased incidence and severity with advancing age in the study. Majority of HG PIN cases in our study noted in (70-79 years of age) 4. The risk of carcinoma is more in cases of High Grade PIN (68.42%) than in low grade PIN (17.64%) 5. This warrants are need for repeat prostatic biopsies to diagnose the invasive carcinoma in patient with High grade PIN.