Grypari Ioanna Maria, Logotheti Souzana, Lazaris Andreas C, Kallidonis Panagiotis, Fokaefs Eleutherios, Melachrinou Maria, Zolota Vasiliki, Tzelepi Vasiliki
University of Patras, Patras, Greece.
National and Kapodistrian University of Athens, Athens, Greece.
Int J Surg Pathol. 2020 Dec;28(8):918-924. doi: 10.1177/1066896920920357. Epub 2020 May 26.
Intraductal carcinoma of the prostate (IDCp) is a distinct neoplastic entity, and although recognized for some time, it was included for the first time in the histologic classification of prostate cancer in the 2016 publication of World Health Organization. IDCp represents an intraductal or intra-acinar proliferation of malignant cells, with preservation of the basal cell layer. Even though IDCp is usually accompanied by a high-grade invasive component, low-grade invasive carcinoma can rarely be seen adjacent to the lesion. Even rarer is the incidence of isolated IDCp in needle biopsies, while a few such cases have been reported in prostatectomy specimens. We report 2 cases with isolated IDCp without any invasive component. A review of the literature is performed including the diagnostic challenges of IDCp and its morphologic mimics, immunohistochemical markers, molecular aspects, and prognostic implications. Even though it is not yet clear whether IDCp represents an intraductal spread of invasive cancer or a precursor of invasive carcinoma, the existence of isolated IDCp reinforces the idea that, at least in some of the cases, IDCp is a precancerous lesion. Further molecular studies need to be performed in order to clarify its pathogenesis.
前列腺导管内癌（IDCp）是一种独特的肿瘤实体，尽管其已被认识一段时间，但在世界卫生组织2016年发布的前列腺癌组织学分类中首次被纳入。IDCp表现为恶性细胞的导管内或腺泡内增殖，同时保留基底细胞层。尽管IDCp通常伴有高级别浸润成分，但在病变附近很少能见到低级别浸润性癌。在针吸活检中孤立性IDCp的发生率更为罕见，而在前列腺切除标本中已有少数此类病例报道。我们报告2例孤立性IDCp且无任何浸润成分的病例。本文对文献进行了综述，内容包括IDCp的诊断挑战及其形态学模拟物、免疫组化标志物、分子特征和预后意义。尽管目前尚不清楚IDCp是代表浸润性癌的导管内播散还是浸润性癌的前驱病变，但孤立性IDCp的存在强化了这样一种观点，即至少在某些病例中，IDCp是一种癌前病变。需要进一步开展分子研究以阐明其发病机制。
