Lobo Anandi, Cheng Liang
Department of Pathology and Laboratory Medicine, Kapoor Centre for Pathology and Urology, Raipur, India.
Department of Pathology and Laboratory Medicine, Department of Surgery (Urology), Brown University Warren Alpert Medical School, the Legorreta Cancer Center at Brown University, Brown University Health, Providence, RI, USA.
Endocr Pathol. 2025 Jul 23;36(1):28. doi: 10.1007/s12022-025-09871-2.
Neuroendocrine tumors (NETs) of the prostate gland represent a distinct entity within the spectrum of prostate cancer, characterized by neuroendocrine differentiation on morphology and unique clinical behavior. Despite their clinical significance, there remains a lack of consensus regarding their diagnosis, classification, immunohistochemical evaluation, and management. A comprehensive understanding of the molecular and clinical heterogeneity of prostate NETs is essential for developing tailored treatment strategies and improving patient outcomes. Over the years, there has been a continuous effort to refine the terminology and classification of neuroendocrine tumors of the prostate. The current WHO 2022 classification scheme for genitourinary neuroendocrine neoplasms provides a standardized framework. However, given the substantial clinical and molecular heterogeneity of prostate NETs, there is an emerging need for an organ-specific classification system that better captures the biological and clinical diversity of these tumors. In this review, we propose a novel classification system for neuroendocrine neoplasms (NENs) of the prostate that integrates both histomorphology and clinical context. With the growing role of liquid biopsy and molecular biomarkers, there is a shift towards more precise, real-time detection of disease progression and treatment resistance. This review highlights the importance of a more nuanced, biologically and clinically informed approach to the diagnosis and management of prostate NETs. A dedicated classification system, combined with advancements in precision genomics and targeted therapies, holds significant promise for improving outcomes in patients with these rare and challenging tumors.
前列腺神经内分泌肿瘤（NETs）是前列腺癌谱系中的一种独特实体，其形态学表现为神经内分泌分化，临床行为独特。尽管它们具有临床意义，但在诊断、分类、免疫组化评估和管理方面仍缺乏共识。全面了解前列腺NETs的分子和临床异质性对于制定个性化治疗策略和改善患者预后至关重要。多年来，一直在不断努力完善前列腺神经内分泌肿瘤的术语和分类。目前世界卫生组织2022年泌尿生殖系统神经内分泌肿瘤分类方案提供了一个标准化框架。然而，鉴于前列腺NETs存在显著的临床和分子异质性，迫切需要一个器官特异性分类系统，以更好地体现这些肿瘤的生物学和临床多样性。在本综述中，我们提出了一种新的前列腺神经内分泌肿瘤（NENs）分类系统，该系统整合了组织形态学和临床背景。随着液体活检和分子生物标志物的作用日益增强，正朝着更精确、实时地检测疾病进展和治疗耐药性转变。本综述强调了采用更细致入微、基于生物学和临床知识的方法来诊断和管理前列腺NETs的重要性。一个专门的分类系统，结合精准基因组学和靶向治疗的进展，有望显著改善这些罕见且具有挑战性的肿瘤患者的治疗结果。
