Digital Quantification of Five High-Grade Prostate Cancer Patterns, Including the Cribriform Pattern, and Their Association With Adverse Outcome

作者：Iczkowski Kenneth A^*; Torkko Kathleen C; Kotnis Gregory R; Wilson R Storey; Huang Wei; Wheeler Thomas M; Abeyta Andrea M; La Rosa Francisco G; Cook Shelly; Werahera Priya N; Lucia M Scott

来源：American Journal of Clinical Pathology, 2011, 136(1): 98-107.

DOI：10.1309/AJCPZ7WBU9YXSJPE

• Cribriform
• Papillary
• Pattern
• Prostate cancer
• Gleason
• Grading
• Digital

Proper grading of the cribriform prostate cancer pattern has not previously been supported by outcome-based evidence. Among 153 men who underwent radical prostatectomy, 76 with prostate-specific antigen (PSA) failure (>= 0.2 ng/mL [0.2 mu g/L]) were matched to 77 without failure. Frequencies of high-grade patterns included fused small acini, 83.7%; papillary, 52.3%; large cribriform, 37.9%; small (<= 12 lumens) cribriform, 17.0%; and individual cells, 22.9%. A cribriform pattern was present in 61% (46/76) of failures but 16% (12/77) of nonfailures (P < .0001). Multivariate analysis showed the cribriform pattern had the highest odds ratio for PSA failure, 5.89 (95% confidence interval, 2.53-13.70; P < .0001). The presence of both large and small cribriform patterns was significantly linked to failure. The cumulative odds ratio of failure per added square millimeter of cribriform pattern was 1.173 (P = .008), higher than for any other pattern. All 8 men with a cribriform area sum of 25 mm(2) or more had failure (range, 33-930). Regrading cribriform cancer as Gleason 5 improved the grade association with failure, although half of all cases with individual cells also had a cribriform pattern, precluding a precise determination of the independent importance of the latter. The cribriform pattern has particularly adverse implications for outcome.

• 出版日期2011-7