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Abstract
Several morphological lesions have been proposed that may act as potential precursor lesions of prostate cancer. These are the morphologically distinct entities of focal atrophy or post-atrophic hyperplasia (PAH), atypical adenomatous hyperplasia (AAH) or adenosis, and prostatic intraepithelial neoplasia (PIN). The diagnostic criteria of low-and high-grade PIN (LGPIN and HGPIN, respectively) and of lesions suspicious for cancer (LSC) have been established.
In the present review, we present the current knowledge about the precursor lesions of prostate cancer. We focus on the epidemiology, pathogenesis, clinical markers, and differential diagnosis of PIN. The similarities between HGPIN and prostate cancer are also discussed. Furthermore, potential markers and management strategies (that is, repeat biopsy, chemoprevention, radical prostatectomy, radiotherapy) are outlined along with updated recommendations.
| Abbreviations | ||
| AAH | = | atypical adenomatous hyperplasia |
| AMARC | = | alpha-methylacyl coenzyme A racemase |
| AR | = | androgen receptor |
| ASAP | = | atypical small acinar proliferation |
| BPH | = | benign prostatic hyperplasia |
| EGFr | = | epidermal growth factor receptor |
| FISH | = | fluorescence in situ hybridization |
| GTC | = | green tea catechin |
| HDAC | = | histone deacetylase |
| HGPIN | = | high-grade prostatic intraepithelial neoplasia |
| LGPIN | = | low-grade prostatic intraepithelial neoplasia |
| LSC | = | lesion suspicious for cancer |
| PAH | = | post-atrophic hyperplasia |
| PCNA | = | proliferating cell nuclear antigen |
| PDGF | = | platelet-derived growth factor |
| PIN | = | prostatic intraepithelial neoplasia |
| PSA | = | prostate specific antigen |
| TRAMP | = | transgenic adenocarcinoma of mouse prostate model |
| TURP | = | transurethral prostatectomy |
| Abbreviations | ||
| AAH | = | atypical adenomatous hyperplasia |
| AMARC | = | alpha-methylacyl coenzyme A racemase |
| AR | = | androgen receptor |
| ASAP | = | atypical small acinar proliferation |
| BPH | = | benign prostatic hyperplasia |
| EGFr | = | epidermal growth factor receptor |
| FISH | = | fluorescence in situ hybridization |
| GTC | = | green tea catechin |
| HDAC | = | histone deacetylase |
| HGPIN | = | high-grade prostatic intraepithelial neoplasia |
| LGPIN | = | low-grade prostatic intraepithelial neoplasia |
| LSC | = | lesion suspicious for cancer |
| PAH | = | post-atrophic hyperplasia |
| PCNA | = | proliferating cell nuclear antigen |
| PDGF | = | platelet-derived growth factor |
| PIN | = | prostatic intraepithelial neoplasia |
| PSA | = | prostate specific antigen |
| TRAMP | = | transgenic adenocarcinoma of mouse prostate model |
| TURP | = | transurethral prostatectomy |