Atrophy (A) in Specimens of Radical Prostatectomy (RP): Is There Topographic Relation to High-Grade Prostatic Intraepithelial Neoplasia (HGPIN) or Cancer (CA)?
AAAV Brasil, A Billis, WJ Favaro, VHA Cagnon, U Ferreira. School of Medicine, University of Campinas (Unicamp), Campinas, Brazil
Background: It is controversial whether there is any relationship of inflammatory atrophy (IA) to prostate cancer. It has been suggested that the proliferative epithelium in IA may progress to HGPIN and/or CA. The aim of this study was to find any possible correlation among the extent of the lesions, the frequency of combined lesions in the same quadrant and the distance among lesions in specimens of RP.
Design: Partial and complete atrophy were considered. We studied the frequency of quadrants showing: only atrophy A, A+HGPIN, A+CA, or A+HGPIN+CA. Extent of atrophy, HGPIN and CA was evaluated by a semiquantitative point-count method previously described. Points were considered coincident whenever atrophy and HGPIN or CA were seen in a distance <5mm; non-coincident whenever in a distance >5mm. The means were compared using the Kruskal-Wallis and the Mann-Whitney tests. For the comparison of extent we used the Spearman correlation coefficient.
Results: A total of 3186 quadrants from 100 whole-mount consecutive surgical specimens were examined. The mean (range) of quadrants showing only A, A+HGPIN, A+CA, and A+HGPIN+CA was 4.88 (0-24), 3.97 (0-14), 1.16 (0-7), and 0.65 (0-4) respectively (p<0.01); considering only foci of IA was 3.29 (0-21), 2.51 (0-11), 0.77 (0-6), and 0.44 (0-4), (p<0.01). No partial atrophy foci with chronic inflammation were seen. The mean (range) of coincident points was 1.12 (0-7) and non-coincident 12.05 (0-65) (p<0.01); considering only foci of IA was 0.81 (0-7) and 8.37 (0-60) (p<0.01). There was no significant correlation between extent of A (r=0.01, p=0.88) or IA (r=0.05, p=0.64) with extent of HGPIN. There was a significant negative correlation of extent of A (r=-0.23, p=0.02) or IA (r=-0.27, p=0.01) with extent of CA.
Conclusions: In specimens of radical prostatectomy most of the quadrants show only atrophy (with or without inflammation). Extent of atrophy did not correlate with extent of HGPIN or carcinoma and the foci of A or IA are significantly located in a distance >5mm from HGPIN and/or CA comparing to foci in a distance <5mm . The results seem to favor a lack of topographical association among atrophy, HGPIN and carcinoma. A further finding in this study was absence of chronic inflammation in partial atrophy foci.
Category: Genitourinary (including renal tumors)
Monday, March 22, 2010 1:00 PM
Poster Session II # 105, Monday Afternoon