Sarbay Billur Cosan, Kir Gozde, Topal Cumhur Selcuk, Gumus Eyup
Pathology Department, Umraniye Education and Research Hospital, Istanbul, Turkey.
Pathology Department, Umraniye Education and Research Hospital, Istanbul, Turkey.
Pathol Res Pract. 2014 Sep;210(9):554-7. doi: 10.1016/j.prp.2014.03.003. Epub 2014 Mar 30.
There is now increased understanding that invasive cribriform carcinoma is a relatively aggressive disease. In some recent publications, the recommendation is that all cribriform patterns be classified as Gleason pattern (GP) 4 rather than GP 3.
We assessed the cribriform foci (CF) associated with the more definitive patterns 3, 4, and 5 elsewhere on the 185 radical prostatectomy specimens and evaluated the association of the cribriform pattern with extraprostatic extension, surgical margin.
CF were more frequently observed in cases with definitive patterns 4 and 5 than in cases with pattern 3 (all cases with pattern 5 exhibited CF). Cases with Gleason score 3+3 and CF were more frequently associated with extraprostatic extension, and a positive surgical margin.
Our results demonstrate that diagnosing all cribriform patterns as at least GP 4 would significantly affect further therapeutic options and prognosis. However, as many of these modifications are empirical and supported by only a few studies, long-term follow-up studies with clinical endpoints are necessary to validate these recommendations.
目前人们越来越认识到浸润性筛状癌是一种侵袭性相对较强的疾病。在最近的一些出版物中，建议将所有筛状模式归为Gleason模式（GP）4而非GP 3。
我们评估了185例根治性前列腺切除术标本中其他部位与更明确的模式3、4和5相关的筛状病灶（CF），并评估了筛状模式与前列腺外扩展、手术切缘的相关性。
与模式3的病例相比，在模式4和5的病例中更频繁地观察到CF（所有模式5的病例均表现出CF）。Gleason评分为3+3且有CF的病例更常与前列腺外扩展和手术切缘阳性相关。
我们的结果表明，将所有筛状模式诊断为至少GP 4会显著影响进一步的治疗选择和预后。然而，由于这些修改大多是经验性的且仅得到少数研究的支持，因此需要进行以临床终点为指标的长期随访研究来验证这些建议。
