TY - JOUR
T1 - Cribriform prostate cancer
T2 - Morphologic criteria enabling a diagnosis, based on survey of experts
AU - Iczkowski, Kenneth A.
AU - van Leenders, Geert J.L.H.
AU - Tarima, Sergey
AU - Wu, Ruizhe
AU - Van der Kwast, Theodorus
AU - Berney, Daniel M.
AU - Evans, Andrew J.
AU - Wheeler, Thomas M.
AU - Ro, Jae Y.
AU - Samaratunga, Hemamali
AU - Delahunt, Brett
AU - Srigley, John
AU - Varma, Murali
AU - Tsuzuki, Toyonori
AU - Egevad, Lars
N1 - Copyright © 2021 Elsevier Inc. All rights reserved.
PY - 2021/6
Y1 - 2021/6
N2 - Among four sub-patterns of Gleason grade 4 prostate cancer, voluminous evidence supports that the cribriform pattern holds an unfavorable prognostic impact, as compared with poorly-formed, fused, or glomeruloid. The International Society of Urological Pathology (ISUP) recommends specifying whether invasive grade 4 cancer is cribriform. Recently, ISUP experts published a consensus definition of cribriform pattern highlighting criteria that distinguish it from mimickers. The current study aimed to analyze morphologic features separately to identify those that define the essence of the cribriform pattern. Thirty-two selected photomicrographs were classified by 12 urologic pathologists as: definitely cribriform cancer, probably cribriform, unsure, probably not cribriform, or definitely not cribriform. Consensus was defined as 9/12 agree or disagree, with ≤1 strongly supporting the opposite choice. Final consensus was achieved in 21 of 32 cases. Generalized estimating equation (GEE) model with logit link was fitted to estimate effect of multiple morphologic predictors. Fisher exact test was used for categorical findings. Presence of intervening stroma precluded calling cribriform cancer (p = 0.006). Mucin presence detracted (p = 0.003) from willingness to call cribriform cancer (only 3 cases had mucin). Lumen number was associated with cribriform consensus (p = 0.0006), and all consensus cases had ≥9 lumens. Predominant papillary pattern or an irregular outer boundary detracted (p = NS). Invasive cribriform carcinoma should have absence of intervening stroma, and usually neither papillary pattern, irregular outer boundary, nor very few lumens. Setting the criteria for cribriform will help prevent over- or undercalling this important finding.
AB - Among four sub-patterns of Gleason grade 4 prostate cancer, voluminous evidence supports that the cribriform pattern holds an unfavorable prognostic impact, as compared with poorly-formed, fused, or glomeruloid. The International Society of Urological Pathology (ISUP) recommends specifying whether invasive grade 4 cancer is cribriform. Recently, ISUP experts published a consensus definition of cribriform pattern highlighting criteria that distinguish it from mimickers. The current study aimed to analyze morphologic features separately to identify those that define the essence of the cribriform pattern. Thirty-two selected photomicrographs were classified by 12 urologic pathologists as: definitely cribriform cancer, probably cribriform, unsure, probably not cribriform, or definitely not cribriform. Consensus was defined as 9/12 agree or disagree, with ≤1 strongly supporting the opposite choice. Final consensus was achieved in 21 of 32 cases. Generalized estimating equation (GEE) model with logit link was fitted to estimate effect of multiple morphologic predictors. Fisher exact test was used for categorical findings. Presence of intervening stroma precluded calling cribriform cancer (p = 0.006). Mucin presence detracted (p = 0.003) from willingness to call cribriform cancer (only 3 cases had mucin). Lumen number was associated with cribriform consensus (p = 0.0006), and all consensus cases had ≥9 lumens. Predominant papillary pattern or an irregular outer boundary detracted (p = NS). Invasive cribriform carcinoma should have absence of intervening stroma, and usually neither papillary pattern, irregular outer boundary, nor very few lumens. Setting the criteria for cribriform will help prevent over- or undercalling this important finding.
KW - Consensus
KW - Cribriform
KW - Grade Group
KW - Grading
KW - Prostate Cancer
KW - Societies, Medical/organization & administration
KW - Prognosis
KW - Surveys and Questionnaires/statistics & numerical data
KW - Humans
KW - Neoplasm Grading/methods
KW - Prostatic Neoplasms/classification
KW - Male
KW - Urologists/organization & administration
KW - Photomicrography/methods
KW - Adenocarcinoma/diagnosis
KW - Neoplasm Invasiveness/pathology
KW - Mucins/metabolism
KW - Pathologists/organization & administration
UR - http://www.scopus.com/inward/record.url?scp=85103255761&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85103255761&partnerID=8YFLogxK
U2 - 10.1016/j.anndiagpath.2021.151733
DO - 10.1016/j.anndiagpath.2021.151733
M3 - Article
C2 - 33780691
AN - SCOPUS:85103255761
SN - 1092-9134
VL - 52
SP - 151733
JO - Annals of Diagnostic Pathology
JF - Annals of Diagnostic Pathology
M1 - 151733
ER -