What Is High-Grade Prostatic Intraepithelial Neoplasia?

Intraepithelial neoplasia, also known as intraepithelial neoplasia (IN), is a commonly used diagnostic term in clinical pathological diagnosis and covers atypical hyperplasia or dysplasia of epithelial tissues in multiple organs. The organs involved are Cervical, prostate, endometrial and esophagus, gastrointestinal and other organs of the digestive system. IN is a special stage before the occurrence of epithelial malignant tumors. IN has obvious changes in cell morphology and cell arrangement compared with normal tissues, and there are genetic clonal changes in its genetics. It is invasive in biological behavior. .

Basic Information

Also known as

Intraepithelial tumor

English name

intraepithelial neoplasia

English alias

IN

Visiting department

Oncology

Common locations

Cervical, prostate, endometrial and esophagus, gastrointestinal and other organs of the digestive system

Grade of intraepithelial neoplasia

Classification of intraepithelial neoplasia: There are two types of grade 2 and grade 3 methods. The grade 2 method divides intraepithelial neoplasia into low-grade and high-grade, where low-grade is equivalent to mild to moderate atypical hyperplasia, and high-grade is equivalent to severe atypical hyperplasia or dysplasia or carcinoma in situ. Grade 2 method is widely used in prostate intraepithelial neoplasia. The grade 3 method divides intraepithelial tumors into grade 1, grade 2, and grade 3. Grade 1 corresponds to mild atypical hyperplasia, grade 2 corresponds to moderate atypical hyperplasia, and grade 3 corresponds to severe atypical hyperplasia or dysplasia or carcinoma in situ. Grade 3 method has been widely used in the diagnosis of cervical epithelial lesions.

Several common types of intraepithelial neoplasia

1. Cervical intraepithelial neoplasia (CIN)

Cervical cancer is the most common gynecological malignancy. It is an infectious cancer. It is a cancer that can be prevented and cured. Richart introduced the concept of cervical intraepithelial neoplasia in 1967, including atypical hyperplasia of cells and carcinoma in situ. The risk of CIN developing into carcinoma in situ and invasive carcinoma is 20 times and 7 times that of normal, respectively. The ACOG (American College of Obstetricians and Gynecologists) recommends that all women who are sexually active or older than 18 years of age undergo cervical cytology once a year. When three or more consecutive inspections are satisfactory and the results are normal, the number of inspections may be reduced as appropriate.

2. Vulvar intraepithelial neoplasia (VIN)

Vulvar intraepithelial neoplasia is a precancerous lesion that occurs in the squamous epithelium of the vulva. VIN includes what was previously called vulvar atypical hyperplasia, carcinoma in situ, Bowen's disease, and Keira's proliferative erythema. Intraepithelial lesions of squamous epithelium, such as melanoma in situ, Paget's disease, etc. In 1987, ISSVD (International Society for Research on Vulvovaginal Diseases) and the International Society of Gynecological Pathology decided to name and classify common precancerous lesions of the vulva. Vulvar in situ cancer is vulvar intraepithelial cancer or pre-invasive cancer. The lesion can spread to the entire epithelium, but does not invade the dermis. It grows slowly and can show a variety of appearances, such as red-brown pimples, scaly plaque-like lesions, and granulation Swelling, leukoplakia, or mottled color are slightly higher than those on the skin surface.

3. Pancreatic ductal intraepithelial neoplasia

Hyperplasia and atypical hyperplasia of the pancreatic duct are often seen around the ductal carcinoma of the pancreas. The concept of pan-intraepithelial neoplasia (Pan IN) introduced in recent years includes all kinds of proliferative changes in the pancreatic ducts. Pan IN 1A is the lightest type and contains the hyperplasia states of ductal epithelium such as myeloid metaplasia or hypertrophy and simple hyperplasia. Pan IN is actually very common and can be seen in many cases, but it should be noted when lesions of Pan IN 2 and Pan IN 3 are seen in pancreatic specimens.

4. Penile intraepithelial neoplasia

Penile intraepithelial neoplasia (PIN) is a tissue spectrum of precancerous lesions. It corresponds to lesions of the same name in the female genital tract of the female genital tract and cervix. It is characterized by impaired epithelial maturation, abnormal cell polarity, and nuclear atypicalness. It used to be called mild, moderate, or severe dysplasia, and carcinoma in situ. At present, penile intraepithelial neoplasias , , and III are also used, and penile squamous intraepithelial lesions are also used, with high and low grades. Queyrat's erythema or Bowen's disease is equivalent to high-grade squamous intraepithelial lesions or squamous cell carcinoma in situ. Queyrat erythema is commonly used clinically on the glans and foreskin, while Bowen's disease is often used on the penis. The WHO considers giant genital warts as a precancerous lesion of the penis.

5. Conjunctival intraepithelial neoplasia

Conjunctival intraepithelial neoplasia (CIN) refers to localized neoplastic hyperplasia of the conjunctiva. Such lesions are precancerous and include previously diagnosed atypical hyperplasia of conjunctival epithelium and carcinoma in situ. This disease is a relatively common epithelial tumor of the conjunctiva. Because a small number of lesions will develop into invasive squamous cell carcinoma, it is a precancerous lesion.

6. colorectal intraepithelial neoplasia

Colorectal adenoma is the most common type of polyp in clinical practice, and it can also be called intraepithelial neoplasia. It has tissue structure and cytological atypia. In other words, if there is no tissue structure and cytology atypia, Can not be diagnosed as adenoma. Colorectal adenoma is closely related to colorectal cancer. According to statistics, about 80% of colorectal cancer originates from adenoma malignancy.

References

Huang Xiaochi, Luo Keshu. Intraepithelial neoplasia. Modern clinical medicine. 2008 (3).