Okubo Yoichiro, Sato Shinya, Hasegawa Chie, Koizumi Mitsuyuki, Suzuki Takahisa, Yamamoto Yayoi, Yoshioka Emi, Ono Kyoko, Washimi Kota, Yokose Tomoyuki, Kishida Takeshi, Miyagi Yohei
Department of Pathology, Kanagawa Cancer Center, 2-3-2, Nakao, Asahi-ku, Yokohama, Kanagawa 241-8515, Japan.
Department of Pathology, Kanagawa Cancer Center, 2-3-2, Nakao, Asahi-ku, Yokohama, Kanagawa 241-8515, Japan; Molecular Pathology and Genetics Division, Kanagawa Cancer Center Research Institute, 2-3-2, Nakao, Asahi-ku, Yokohama, Kanagawa 241-8515, Japan.
Hum Pathol. 2023 May;135:99-107. doi: 10.1016/j.humpath.2023.01.008. Epub 2023 Feb 3.
Cribriform pattern and intraductal carcinoma of the prostate (IDC-P) are widely accepted as poor prognostic factors in prostate cancer. However, it remains unclear to what extent the presence of these morphological features in prostate biopsy specimens, as diagnosed by hematoxylin-eosin-stained specimens only, affects the clinicopathological impact. In this study, we summarized the characteristics of the cribriform pattern and IDC-P in 850 prostate biopsy cases. The results showed a statistically significant increase in the incidence of cribriform pattern and IDC-P as grade group (GG) increased (especially in cases ≥ GG4, Chi-square test P < 0.001). The independent risk factors for cribriform pattern and IDC-P in biopsy specimens in the multivariate logistic regression analysis were the former GG, presence of IDC-P, lesion length of the highest GG core, latter GG, presence of the cribriform pattern, number of biopsies obtained, and number of highest GG core. Overall, 125 cases in which radical prostatectomy was conducted after biopsy were selected for further analysis. Multivariate logistic regression analysis using biopsy and surgical specimens confirmed that the presence of the cribriform pattern and IDC-P in biopsy specimens were independent risk factors for lymph node metastasis (odds ratios [95% confidence interval] were 6.54 [1.15-37.05] for the cribriform pattern and 23.71 [1.74-322.42] for IDC-P). The presence of the cribriform pattern and/or IDC-P in a biopsy specimen was a significant factor, even if only partially present, indicating lymph node metastasis. However, further validation is required to predict poor prognostic factors more accurately.
筛状模式和前列腺导管内癌（IDC-P）被广泛认为是前列腺癌的不良预后因素。然而，仅通过苏木精-伊红染色标本诊断的前列腺活检标本中这些形态学特征的存在在多大程度上影响临床病理影响仍不清楚。在本研究中，我们总结了850例前列腺活检病例中筛状模式和IDC-P的特征。结果显示，随着分级组（GG）增加，筛状模式和IDC-P的发生率在统计学上显著增加（特别是在GG≥4的病例中，卡方检验P<0.001）。多变量逻辑回归分析中活检标本中筛状模式和IDC-P的独立危险因素为先前的GG、IDC-P的存在、最高GG核心的病变长度、后来的GG、筛状模式的存在、获取的活检数量以及最高GG核心的数量。总体而言，选择了125例活检后进行根治性前列腺切除术的病例进行进一步分析。使用活检和手术标本的多变量逻辑回归分析证实，活检标本中筛状模式和IDC-P的存在是淋巴结转移的独立危险因素（筛状模式的比值比[95%置信区间]为6.54[1.15-37.05]，IDC-P为23.71[1.74-322.42]）。活检标本中筛状模式和/或IDC-P的存在是一个重要因素，即使只是部分存在，也表明有淋巴结转移。然而，需要进一步验证以更准确地预测不良预后因素。
