McNeal J E, Reese J H, Redwine E A, Freiha F S, Stamey T A
Cancer. 1986 Oct 15;58(8):1714-9. doi: 10.1002/1097-0142(19861015)58:8<1714::aid-cncr2820580823>3.0.co;2-m.
In 46 radical prostatectomy specimens, carcinoma volume and Gleason histologic grade were compared among 21 cancers containing Grade 3 cribriform areas and 25 noncribriform carcinomas. All cribriform cancers but only 44% of the noncribriform cancers were larger than 1.7 ml. Grade 4-5 areas were present in 86% of cribriform cancers and 36% of noncribriform cancers. All 17 cancers larger than 4.0 ml contained Grade 4-5 areas, and 15 of these showed cribriform areas. By contrast, noncribriform Grade 3 areas were found in 45 of 46 carcinomas. In most cases, cribriform carcinoma was predominantly intraductal; cell masses either followed normal duct contours or showed a basal cell layer by routine microscopic study or by immunohistochemical staining for basal cell-specific keratin. Seven cases showed primary origin of cribriform carcinoma within ducts by evolution from intraductal dysplasia, a presumptive premalignant lesion. It was proposed that cribriform carcinoma is equivalent to intraductal Grade 4 cancer, and that many Grade 4 prostate cancers may evolve directly from an identifiable intraductal precursor.
在46份前列腺癌根治术标本中，对21例含有3级筛状区域的癌和25例非筛状癌的癌体积和Gleason组织学分级进行了比较。所有筛状癌中，但只有44%的非筛状癌体积大于1.7 ml。86%的筛状癌和36%的非筛状癌存在4-5级区域。所有17例体积大于4.0 ml的癌均含有4-5级区域，其中15例显示筛状区域。相比之下，46例癌中有45例发现非筛状3级区域。在大多数情况下，筛状癌主要为导管内癌；细胞团要么遵循正常导管轮廓，要么通过常规显微镜检查或基底细胞特异性角蛋白免疫组化染色显示基底细胞层。7例显示筛状癌起源于导管内发育异常（一种推定的癌前病变）向导管内的演变。有人提出，筛状癌相当于导管内4级癌，许多4级前列腺癌可能直接从可识别的导管内前体演变而来。
