Department of Medicine, Vanderbilt University Medical Center, Nashville, TN.
Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN; Department of Urology, Vanderbilt University Medical Center, Nashville, TN.
Urology. 2021 Sep;155:47-54. doi: 10.1016/j.urology.2021.05.028. Epub 2021 May 28.
Intraductal cribriform (IDC) and invasive cribriform morphologies are associated with worse prostate cancer outcomes. Limited retrospective studies have associated IDC and cribriform morphology with germline mutations in DNA repair genes, particularly BRCA2. These findings, which prompted the National Comprehensive Cancer Network (NCCN) Guidelines for Prostate Cancer and Genetic/Familial High- Risk Assessment to consider germline testing for individuals with IDC/cribriform histology, have been questioned in a recent prospective study. A deepened understanding of the molecular mechanisms driving disease aggressiveness in cribriform morphology is critical to provide more clarity in clinical decision making. This review summarizes the current understanding of IDC and cribriform prostate cancer, with an emphasis on clinical outcomes and molecular alterations.
管状内筛状（IDC）和浸润性筛状形态与前列腺癌结局较差相关。有限的回顾性研究将 IDC 和筛状形态与 DNA 修复基因的种系突变相关联，特别是 BRCA2。这些发现促使国家综合癌症网络（NCCN）前列腺癌指南和遗传/家族性高危评估考虑对 IDC/筛状组织学的个体进行种系检测，但最近的一项前瞻性研究对这些发现提出了质疑。深入了解驱动筛状形态疾病侵袭性的分子机制对于临床决策提供更清晰的认识至关重要。本文综述了目前对 IDC 和前列腺癌筛状形态的认识，重点介绍了临床结局和分子改变。
