Division of Urology, Department of Surgical Oncology, University of Toronto, Princess Margaret Cancer Centre, Toronto, Canada; Computational and Experimental Biology Group, NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal.
Division of Urology, Department of Surgical Oncology, University of Toronto, Princess Margaret Cancer Centre, Toronto, Canada.
Eur Urol Focus. 2024 Jan;10(1):146-153. doi: 10.1016/j.euf.2023.08.010. Epub 2023 Sep 10.
The presence of cribriform morphology and intraductal carcinoma (IDC) in prostate biopsies and radical prostatectomy specimens is an adverse prognostic feature that can be used to guide treatment decisions.
To assess how accurately biopsies can detect cribriform morphology and IDC cancer by examining matched biopsy and prostatectomy samples.
DESIGN, SETTING, AND PARTICIPANTS: Patients who underwent radical prostatectomy at The Princess Margaret Cancer Centre between January 2015 and December 2022 and had cribriform morphology and/or IDC in the surgical specimen were included in the study.
We used detection sensitivity to evaluate the level of agreement between biopsy and prostatectomy samples regarding the presence of cribriform morphology and IDC.
Of the 287 men who underwent radical prostatectomy, 241 (84%) had cribriform morphology and 161 (56%) had IDC on final pathology. The sensitivity of prostate biopsy, using radical prostatectomy as the reference, was 42.4% (95% confidence interval [CI] 36-49%) for detection of cribriform morphology and 44.1% (95% CI 36-52%) for detection of IDC. The sensitivity of prostate biopsy for detection of either IDC or cribriform morphology was 52.5% (95% CI 47-58%). Among patients who underwent multiparametric magnetic resonance imaging-guided biopsies, the sensitivity was 54% (95% CI 39-68%) for detection of cribriform morphology and 37% (95% CI 19-58%) for detection of IDC.
Biopsy has low sensitivity for detecting cribriform morphology and IDC. These limitations should be incorporated into clinical decision-making. Biomarkers for better detection of these histological patterns are needed.
Prostate biopsy is not an accurate method for detecting two specific types of prostate cancer cells, called cribriform pattern and intraductal prostate cancer, which are associated with unfavorable prognosis.
前列腺活检和前列腺根治性切除术标本中存在筛状形态和导管内癌（IDC）是预后不良的特征，可用于指导治疗决策。
通过检查配对的活检和前列腺切除术样本，评估活检准确检测筛状形态和 IDC 癌的能力。
设计、设置和参与者：纳入研究的患者在 2015 年 1 月至 2022 年 12 月期间在玛格丽特公主癌症中心接受了根治性前列腺切除术，且手术标本中存在筛状形态和/或 IDC。
我们使用检测灵敏度来评估活检和前列腺切除术样本在筛状形态和 IDC 存在方面的一致性程度。
在 287 名接受根治性前列腺切除术的男性中，241 名（84%）最终病理有筛状形态，161 名（56%）有 IDC。以根治性前列腺切除术为参考，前列腺活检的灵敏度为 42.4%（95%置信区间[CI] 36-49%），用于检测筛状形态；44.1%（95% CI 36-52%）用于检测 IDC。前列腺活检用于检测 IDC 或筛状形态的灵敏度为 52.5%（95% CI 47-58%）。在接受多参数磁共振成像引导活检的患者中，检测筛状形态的灵敏度为 54%（95% CI 39-68%），检测 IDC 的灵敏度为 37%（95% CI 19-58%）。
活检对检测筛状形态和 IDC 的灵敏度较低。这些局限性应纳入临床决策中。需要有生物标志物来更好地检测这些组织学模式。
前列腺活检不是一种准确的方法，无法检测两种特定类型的前列腺癌细胞，即筛状模式和导管内前列腺癌，它们与预后不良有关。
