Urological Survey 30(1)_ing.p65

of associated features including atrophy, inflammation and stromal reaction. Pathologic parameters of HGPIN were correlated with detection of PCa in subsequent biopsy (ies). Results: 66.7% of patients with two or more cores involved by HGPIN had PCa on subsequent biopsy. In contrast, 38.6% of patients with only one core with HGPIN were detected to have PCa (p=0.015, Fishers exact test). Tufted and flat were the most common architectural patterns. The presence of micropapillary HGPIN was associated with greater likelihood of subsequent PCa detection (p=0,041, Pearson x2 test). By multivariate analysis, pattern of HGPIN (micropapillary and cribriform) was the only independent predictor of cancer on rebiopsy (p=0.013, RR 4.586). Other pathologic variables failed to have predictive value for subsequent detection of PCa. Conclusions: Patients with initial diagnosis of HGPIN, which demonstrates micropapillary or cribriform architecture or is present in multiple cores, should be candidates for more aggressive investigation to detect PCa, potentially by early rebiopsy and more aggressive sampling.