Positive Predictive Value of High-Grade Prostatic Intraepithelial Neoplasia in Initial Core Needle Biopsies of Prostate Adenocarcinoma—A Study with Complete Sampling of Hemi-Prostates with Corresponding Negative Biopsy Findings

Mechanisms of Disease: high-grade prostatic intraepithelial neoplasia and other proposed preneoplastic lesions in the prostate

“…By contrast, the number of biopsy specimens positive for HGPIN on initial biopsy was not associated with a raised likelihood of prostate cancer on repeat biopsy in the study by Naya et al 55 The importance of HGPIN on initial biopsy samples as a marker of prostate cancer being diagnosed in repeat biopsy samples has been extensively investigated, but little is known of the actual rate of cancer in the whole prostate in this setting because repeat biopsies could miss the area of cancer. Roustan Delatour et al 57 aimed to define a precise positive predictive value of isolated HGPIN on initial biopsy in predicting cancer in the prostate gland. They found that the positive predictive value of HGPIN was 64%.…”

“…In one study 35% of carcinomas would have been missed if samples at repeat biopsy had been taken only from the side on which positive HGPIN specimens were found previously. 57 Most cases of carcinoma (80-90%) are detected on the first repeat biopsy after a HGPIN diagnosis. Persistent HGPIN might also be detected in 5-43% of cases.…”

Bioluminescent mouse models of prostate cancer progression and therapy

“…Prostate cancer was diagnosed in significantly more men with HGPIN on initial biopsy than in those with benign prostates even after taking into account age, PSA levels and sign out pathologist. However, other studies find no relationship between the two but note that HGPIN is still a useful marker for clinically significant prostate adenocarcinoma (Delatour and Mai 2008).…”