Current significance of the finding of high grade prostatic intraepithelial neoplasia in the prostate biopsy

Introduction: High grade prostatic intraepithelial neoplasia (HGPIN) is regarded as a precursor of prostate cancer (PC). However, its relationship to cancer has changed throughout the literature, being currently poorly defined and remains controversial for urologists in their clinical practice. Because of his frequency and the impact on patient outcomes that the lack of consensus clinical attitude could carry out, it seems advisable to review the understanding of this disease. Objective: The aim of this literature review is to summarize the main features of this entity (histopathology, molecular, epidemiological) and evaluate their relationship with prostate adenocarcinoma, explaining the variation of incidence seen in the literature and the clinical significance of their finding. Material and methods: Review of the literature, based on the research and analysis of publications found in Pubmed with the words "prostate" and "intraepithelial neoplasms". Results: The HGPIN detection rate has increased to the extent that it has increased the number of punctures in prostate biopsies. With the current biopsy schemes (10-12 punctures), the detection rate of PC in repeat biopsies is similar in patients with and without isolated HGPIN. However, HGPIN multifocality predicts increased risk of PC detection in repeat biopsy. Conclusion: HGPIN detection is common with current biopsy schemes. Its genetic relationship with PC is clear and its multifocality is the most important predictor factor of PC. (C) 2013 AEU. Published by Elsevier Espana, S.L. All rights reserved.