Clinical significance of proliferative inflammatory atrophy in prostate biopsy

INPP4B is highly expressed in prostate intermediate cells and its loss of expression in prostate carcinoma predicts for recurrence and poor long term survival

“…PIA lesions are often associated with PIN and carcinoma in prostatectomy sections and the lesions share morphological similarities and genetic abnormalities. For example, PIA, PIN and prostate carcinoma exhibit chromosome 8 abnormalities, increased Bcl‐2 protein and decreased NKX3.1 and p27 kip1 . Repeated bouts of injury to the prostate epithelium results in PIA lesions enriched with intermediate cells, which have been postulated as the cell of origin of prostate cancer .…”

Clinical Significance of Proliferative Inflammatory Atrophy in Negative Prostatic Biopsies

“…To date, no clinical study has supported the hypothesis that PIA is involved in prostate carcinogenesis . We have recently observed that PIA is present in around one third of negative prostatic biopsies (PBs).…”

Is high‐grade prostatic intraepithelial neoplasia (HGPIN) a reliable precursor for prostate carcinoma? Implications for clonal evolution and early detection strategies

“…Some other lesions (e.g. proliferative inflammatory atrophy, PIA) have been proposed as an even earlier putative precursor lesion of PCA [2][3][4]. However, the evidence is controversial, with atrophy and PIA even associated with a lower risk of PCA [5][6][7][8].…”

“…The lack of epidemiological studies and the vague morphological definition of PIA, with inter-observer variability reaching 51%, preclude any further conclusions [9]. Some evidence, however, has suggested that PIA is a putative precursor lesion of HGPIN [2][3][4], which does not change the essence of the considerations outlined below.…”