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Yang L, Li Z, Liang X, Xu J, Cai Y, Huang C, Zhang M, Yao J, Song B. Corrigendum: Radiomic machine learning and external validation based on 3.0T mpMRI for prediction of intraductal carcinoma of prostate with different proportion. Front Oncol 2024; 14:1401121. [PMID: 38634050 PMCID: PMC11022688 DOI: 10.3389/fonc.2024.1401121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 03/18/2024] [Indexed: 04/19/2024] Open
Abstract
[This corrects the article DOI: 10.3389/fonc.2022.934291.].
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Affiliation(s)
- Ling Yang
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Zhengyan Li
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Xu Liang
- Department of Radiology, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Jingxu Xu
- Department of Research Collaboration, R&D center, Beijing Deepwise & League of PHD Technology Co., Ltd., Beijing, China
| | - Yusen Cai
- Department of Research Collaboration, R&D center, Beijing Deepwise & League of PHD Technology Co., Ltd., Beijing, China
| | - Chencui Huang
- Department of Research Collaboration, R&D center, Beijing Deepwise & League of PHD Technology Co., Ltd., Beijing, China
| | - Mengni Zhang
- Department of Pathology, West China Hospital of Sichuan University, Chengdu, China
| | - Jin Yao
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Bin Song
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
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Watanabe T, Honma Y, Yonemori K, Sunami K, Yoshimoto S, Mori T. High-grade intraductal carcinoma of the parotid gland harboring CTNNA1::ALK rearrangement: Changes in genetic status using genetic testing during treatment with an ALK inhibitor. Head Neck 2024; 46:E26-E31. [PMID: 38018800 DOI: 10.1002/hed.27587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/02/2023] [Accepted: 11/11/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Salivary gland carcinomas harboring anaplastic lymphoma kinase (ALK) rearrangements are rare. Here, we present the pathological characteristics, clinical course, and changes in the genetic status of a salivary gland carcinoma harboring a catenin alpha 1 (CTNNA1)::ALK rearrangement during treatment with an ALK tyrosine kinase inhibitor (TKI). METHODS A 59-year-old man with a parotid tumor and cervical lymph node metastases underwent total parotidectomy and radical neck dissection. One month after completion of postoperative radiotherapy, the patient experienced multiple recurrences. RESULTS Subsequent treatment with the ALK-TKI alectinib was initially effective against the intraductal carcinoma harboring CTNNA1::ALK rearrangement and TP53 mutation. However, 10 months later the patients' condition deteriorated, and an additional phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA) mutation was detected. The patient ultimately succumbed to multiple organ failure. CONCLUSION The clinical course suggested the concurrent emergence of TP53 and PIK3CA mutations and ALK-TKI drug-selective growth of non-ALK rearrangement gene tumor cells.
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Affiliation(s)
- Takane Watanabe
- Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Yoshitaka Honma
- Department of Head and Neck, Esophageal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Kan Yonemori
- Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Kuniko Sunami
- Department of Laboratory Medicine, National Cancer Center Hospital, Tokyo, Japan
| | - Seiichi Yoshimoto
- Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Taisuke Mori
- Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan
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Cochran BL, Eliseo S, Vaughn A, Van Der Horn TL, Ferrara E, Edwards J. Treated Primary Cutaneous Malignant Melanoma With Later Metastasis Found in Clinical Presentation of Left Axilla Lymphadenopathy: A Case Report. Cureus 2024; 16:e54694. [PMID: 38389566 PMCID: PMC10883347 DOI: 10.7759/cureus.54694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2024] [Indexed: 02/24/2024] Open
Abstract
This case report details the rare instance of metastatic spread of cutaneous malignant melanoma to the breast in a 50-year-old female. The patient presented with a palpable axillary mass confirmed to be metastasis despite excision and closure of the primary malignancy. The mass seen in clinical and radiological presentations presented with features of complicated differentiation from a primary breast tumor. Biopsy and staining with immunohistochemical markers S100 and Sox10 played a critical role in confirming the melanocytic origin of this metastatic lesion. Breast metastases are associated with poor prognosis, and this case emphasizes the importance of in-depth evaluations for patients with a history of malignant melanoma and the need for ongoing clinical awareness in this field.
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Affiliation(s)
- Brigitte L Cochran
- Osteopathic Medicine, Philadelphia College of Osteopathic Medicine, Moultrie, USA
| | - Sara Eliseo
- Osteopathic Medicine, Philadelphia College of Osteopathic Medicine, Moultrie, USA
| | - Austin Vaughn
- Radiology, Lake Erie College of Osteopathic Medicine, Bradenton, USA
| | | | - Enzo Ferrara
- Osteopathic Medicine, Philadelphia College of Osteopathic Medicine, Suwanee, USA
| | - Jamie Edwards
- Interventional Radiology, St. Vincent's Medical Center, Jacksonville, USA
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Naito Y, Kato M, Nagayama J, Sano Y, Matsuo K, Inoue S, Sano T, Ishida S, Matsukawa Y, Tsuzuki T, Akamatsu S. Recent insights on the clinical, pathological, and molecular features of intraductal carcinoma of the prostate. Int J Urol 2024; 31:7-16. [PMID: 37728330 DOI: 10.1111/iju.15299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 09/06/2023] [Indexed: 09/21/2023]
Abstract
Intraductal carcinoma of the prostate, a unique histopathologic entity that is often observed (especially in advanced prostate cancer), is characterized by the proliferation of malignant cells within normal acini or ducts surrounded by a basement membrane. Intraductal carcinoma of the prostate is almost invariably associated with an adjacent high-grade carcinoma and is occasionally observed as an isolated subtype. Intraductal carcinoma of the prostate has been demonstrated to be an independent poor prognostic factor for all stages of cancer, whether localized, de novo metastatic, or castration-resistant. It also has a characteristic genetic profile, including high genomic instability. Recognizing and differentiating it from other pathologies is therefore important in patient management, and morphological diagnostic criteria for intraductal carcinoma of the prostate have been established. This review summarizes and outlines the clinical and pathological features, differential diagnosis, molecular aspects, and management of intraductal carcinoma of the prostate, as described in previous studies. We also present a discussion and future perspectives regarding intraductal carcinoma of the prostate.
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Affiliation(s)
- Yushi Naito
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Masashi Kato
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Jun Nagayama
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Yuta Sano
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Kazuna Matsuo
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Satoshi Inoue
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Tomoyasu Sano
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Shohei Ishida
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Yoshihisa Matsukawa
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Toyonori Tsuzuki
- Department of Surgical Pathology, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Shusuke Akamatsu
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
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Koufopoulos N, Ieronimaki AI, Zacharatou A, Gouloumis AR, Leventakou D, Boutas I, Dimas DT, Kontogeorgi A, Sitara K, Khaldi L, Zanelli M, Palicelli A. A Case of Prostatic Signet-Ring Cell-like Carcinoma with Pagetoid Spread and Intraductal Carcinoma and Long-Term Survival: PD-L1 and Mismatch Repair System Proteins (MMR) Immunohistochemical Evaluation with Systematic Literature Review. J Pers Med 2023; 13:1016. [PMID: 37374005 DOI: 10.3390/jpm13061016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/16/2023] [Accepted: 06/18/2023] [Indexed: 06/29/2023] Open
Abstract
Prostatic adenocarcinoma (PA) is the second most common malignancy in men globally. Signet-ring cell-like adenocarcinoma (SRCC) is a very rare PA subtype, with around 200 cases reported in the English literature. Histologically, the tumor cells show a vacuole compressing the nucleus to the periphery. Pagetoid spread in acini and ducts is usually related to metastases from urothelial or colorectal carcinomas, less commonly associated with intraductal carcinoma (IC); histologically, the tumor cells grow between the acinar secretory and basal cell layers. To our knowledge, we report the first prostatic SRCC (Gleason score 10, stage pT3b) associated with IC and pagetoid spread to prostatic acini and seminal vesicles. To our systematic literature review (PRISMA guidelines), it is the first tested case for both PD-L1 (<1% of positive tumor cells, clone 22C3) and mismatch repair system proteins (MMR) (MLH1+/MSH2+/PMS2+/MSH6+). We found no SRCC previously tested for MMR, while only four previous cases showed high expression of another PD-L1 clone (28-8). Finally, we discussed the differential diagnoses of prostatic SRCC.
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Affiliation(s)
- Nektarios Koufopoulos
- Second Department of Pathology, Medical School, National and Kapodistrian University of Athens, Attikon University Hospital, 15772 Athens, Greece
| | - Argyro-Ioanna Ieronimaki
- Second Department of Pathology, Medical School, National and Kapodistrian University of Athens, Attikon University Hospital, 15772 Athens, Greece
| | - Andriani Zacharatou
- Second Department of Pathology, Medical School, National and Kapodistrian University of Athens, Attikon University Hospital, 15772 Athens, Greece
| | - Alina Roxana Gouloumis
- Second Department of Pathology, Medical School, National and Kapodistrian University of Athens, Attikon University Hospital, 15772 Athens, Greece
| | - Danai Leventakou
- Second Department of Pathology, Medical School, National and Kapodistrian University of Athens, Attikon University Hospital, 15772 Athens, Greece
| | - Ioannis Boutas
- Breast Unit, Rea Maternity Hospital, P. Faliro, 17564 Athens, Greece
| | - Dionysios T Dimas
- Breast Unit, Athens Medical Center, Psychiko Clinic, 11525 Athens, Greece
| | - Adamantia Kontogeorgi
- Third Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, Attikon University Hospital, 15772 Athens, Greece
| | - Kyparissia Sitara
- Department of Internal Medicine, "Elpis" General Hospital of Athens, 11522 Athens, Greece
| | - Lubna Khaldi
- Pathology Department "Saint Savvas" Anti-Cancer Hospital, 10447 Athens, Greece
| | - Magda Zanelli
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Andrea Palicelli
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
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Takeshita N, Sakamoto S, Yamada Y, Sazuka T, Imamura Y, Komiya A, Akakura K, Sato N, Nakatsu H, Kato T, Sugimoto M, Tsuzuki T, Ichikawa T. Detection of intraductal carcinoma in prostate cancer patients with small tumor volume. Prostate 2023; 83:580-589. [PMID: 36762419 DOI: 10.1002/pros.24492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 11/16/2022] [Accepted: 01/23/2023] [Indexed: 02/11/2023]
Abstract
OBJECTIVES The purpose of this study was to investigate intraductal carcinoma of the prostate (intraductal carcinoma) and significant cancer (SC) in patients with small tumor volume (<0.5 cm3 ) in prostatectomy specimens. METHODS Data from 639 patients undergoing radical prostatectomy between April 2006 and December 2017 at Chiba University Hospital and 2 affiliated institutions were retrospectively reviewed. Tumor volume in prostatectomy specimens was measured, and with a tumor volume of less than 0.5 cm3 , the presence of intraductal carcinoma and SC was examined. SC was defined as one that did not meet the definition of pathological insignificant cancer (organ-confined cancer, Grade Group 1, tumor volume < 0.5 cm3 ). The number of patients who met four active surveillance (AS) protocols was also examined. RESULTS A total of 83 patients with tumor volume < 0.5 cm3 were identified in this study population (SC: 43 patients [52%], intraductal carcinoma: 5 patients [6%]). The median follow-up was 34.6 months (range: 18-57 months). Four (5%) developed biochemical recurrence. The number of positive biopsy cores ≥ 2 was an independent predictor of SC in patients with tumor volume < 0.5 cm3 (hazard ratio: 4.39; 95% confidence interval: 1.67-11.56; p = 0.003). In tumor volume < 0.5 cm3 , tumor volume was significantly correlated with the International Society of Urological Pathology Grade Group (1 vs. 4-5, p = 0.002) and the presence of intraductal carcinoma (p = 0.004). In intraductal carcinoma-positive cases, four of five patients (80%) had the predictor of SC, which was two or more positive biopsy cores. Of the four AS protocols, the criteria for Prostate Cancer Research International: Active Surveillance were met most frequently in 46 cases (55%) of tumor volume less than 0.5 cm3 if targeted biopsy by magnetic resonance imaging was available. CONCLUSION The results of the present study suggest that intraductal carcinoma was present even in cases with small tumor volumes. Grade Group and intraductal carcinoma showed a positive correlation with tumor volume.
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Affiliation(s)
- Nobushige Takeshita
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Shinichi Sakamoto
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Yasutaka Yamada
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Tomokazu Sazuka
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Yusuke Imamura
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Akira Komiya
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Koichiro Akakura
- Department of Urology, Japan Community Health Care Organization, Tokyo, Japan
| | - Nobuo Sato
- Department of Urology, Funabashi Municipal Medical Center, Chiba, Japan
| | | | - Takuma Kato
- Department of Urology, Kagawa University Faculty of Medicine, Kagawa, Japan
| | - Mikio Sugimoto
- Department of Urology, Kagawa University Faculty of Medicine, Kagawa, Japan
| | - Toyonori Tsuzuki
- Department of Surgical Pathology, Aichi Medical University Hospital, Aichi, Japan
| | - Tomohiko Ichikawa
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
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Oufattole J, Dey T, D'Amico AV, van Leenders GJLH, Acosta AM. Cribriform morphology is associated with higher risk of biochemical recurrence after radical prostatectomy in patients with Grade Group 5 prostate cancer. Histopathology 2023; 82:1089-1097. [PMID: 36939057 DOI: 10.1111/his.14901] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/14/2023] [Accepted: 02/23/2023] [Indexed: 03/21/2023]
Abstract
AIMS Grade Group 5 (GG5) prostate cancer (PCa) is associated with a high risk of disease recurrence after radical prostatectomy (~75% at 5 years). However, this is a heterogeneous category that includes neoplasms with different combinations of Gleason pattern (GP) 4 and 5. Within GP4, large cribriform growth has been associated with adverse disease-specific outcomes in GG2-4 PCa. Less is known about the significance of cribriform morphology and the different histologic patterns of GP5 in GG5 PCa. METHODS AND RESULTS In this study we evaluated the prognostic implications of cribriform morphology (either invasive or intraductal, henceforth "cribriform") and large solid growth or comedonecrosis (comedo/solid) in patients with GG5 PCa. One-hundred and thirty prostatectomies from a single institution were analysed. The presence of comedo/solid components was associated with a higher frequency of concurrent cribriform PCa (85.7% versus 45.9%, P < 0.001), lymphovascular invasion (44.6% versus 27%, P = 0.04), and biochemical recurrence (48.2% versus 28.4%, P = 0.03). The presence of large cribriform growth was associated with a higher frequency of extraprostatic involvement (i.e. pT3a-b; 85.3% versus 68.7%, P = 0.02), positive surgical margins (47.6% versus 29.2%, P = 0.04) and biochemical recurrence (47.6% versus. 18.7%, P = 0.001). Kaplan-Meier analysis demonstrated that GG5 PCa with cribriform or comedo/solid components had a higher probability of biochemical recurrence. Multivariable analysis showed that only cribriform components were an independent predictor of a higher risk of biochemical recurrence in this series. CONCLUSION These findings highlight the importance of reporting the presence of cribriform components in GG5 PCa and suggest that cribriform morphology might help decide postsurgical management in these patients.
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Affiliation(s)
- Jihane Oufattole
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Tanujit Dey
- Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Anthony V D'Amico
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Geert J L H van Leenders
- Department of Pathology, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, The Netherlands
| | - Andres M Acosta
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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Osiecki R, Kozikowski M, Sarecka-Hujar B, Pyzlak M, Dobruch J. Prostate Cancer Morphologies: Cribriform Pattern and Intraductal Carcinoma Relations to Adverse Pathological and Clinical Outcomes-Systematic Review and Meta-Analysis. Cancers (Basel) 2023; 15. [PMID: 36900164 DOI: 10.3390/cancers15051372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 02/16/2023] [Accepted: 02/18/2023] [Indexed: 02/25/2023] Open
Abstract
The present study aimed to assess the association between the cribriform pattern (CP)/intraductal carcinoma (IDC) and the adverse pathological and clinical outcomes in the radical prostatectomy (RP) cohort. A systematic search was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis statement (PRISMA). The protocol from this review was registered on the PROSPERO platform. We searched PubMed®, the Cochrane Library and EM-BASE® up to the 30th of April 2022. The outcomes of interest were the extraprostatic extension (EPE), seminal vesicle invasion (SVI), lymph node metastasis (LNS met), risk of biochemical recurrence (BCR), distant metastasis (MET) and disease-specific death (DSD). As a result, we identified 16 studies with 164 296 patients. A total of 13 studies containing 3254 RP patients were eligible for the meta-analysis. The CP/IDC was associated with adverse outcomes, including EPE (pooled OR = 2.55, 95%CI 1.23-5.26), SVI (pooled OR = 4.27, 95%CI 1.90-9.64), LNs met (pooled OR = 6.47, 95%CI 3.76-11.14), BCR (pooled OR = 5.09, 95%CI 2.23-11.62) and MET/DSD (pooled OR = 9.84, 95%CI 2.75-35.20, p < 0.001). In conclusion, the CP/IDC belong to highly malignant prostate cancer patterns which have a negative impact on both the pathological and clinical outcomes. The presence of the CP/IDC should be included in the surgical planning and postoperative treatment guidance.
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de Barros HA, Remmers S, Luiting HB, van Leenders GJLH, Roobol MJ, Bekers EM, Amin A, Haynes AM, Delprado W, Stricker PD, van der Poel HG, van der Kwast TH, van Leeuwen PJ. Predictive value of Cribriform and Intraductal Carcinoma for the Nomogram-Based Selection of Prostate Cancer Patients for Pelvic Lymph Node Dissection. Urology 2022:S0090-4295(22)00537-4. [PMID: 35803346 DOI: 10.1016/j.urology.2022.04.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 03/22/2022] [Accepted: 04/28/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To assess the predictive value of biopsy-identified cribriform carcinoma and/or intraductal carcinoma (CR/IDC) within the Briganti and MSKCC nomograms predicting lymph node metastasis (LNM) in patients with primary prostate cancer (PCa). METHODS We retrospectively included 393 PCa patients who underwent radical prostatectomy with extended pelvic lymph node dissection at three tertiary referral centers. We externally validated two prediction tools: the Briganti 2012 nomogram and the Memorial Sloan Kettering Cancer Center (MSKCC) nomogram. Both nomograms were augmented with CR/IDC. The original model was compared with the CR/IDC-updated model using the likelihood ratio test. The performance of the prediction tools was assessed using calibration, discrimination, and clinical utility. RESULTS Overall, 109 (28%) men were diagnosed with LNM. Calibration plots of the Briganti and MSKCC nomograms demonstrated an underestimation of the LNM risk across clinically relevant thresholds (≤15%). The addition of CR/IDC to the Briganti nomogram increased the fit of the data (χ2(1)=4.30, p=0.04), but did not improve the area under the curve (AUC) (0.69, 95% CI 0.63-0.75 vs. 0.69, 95% CI 0.64-0.75). Incorporation of CR/IDC in the MSKCC nomogram resulted in an increased fit on the data (χ2(1)=10.04, p<0.01), but did not increase the AUC (0.66, 95% CI 0.60-0.72 vs 0.68, 95% CI 0.62-0.74). The addition of CR/IDC to the Briganti and MSKCC nomograms did not improve the clinical risk prediction. CONCLUSIONS Incorporation of CR/IDC into the two clinically most used pre-radical prostatectomy nomograms does not improve LNM prediction in a multinational, contemporary PCa cohort.
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Yang L, Li Z, Liang X, Xu J, Cai Y, Huang C, Zhang M, Yao J, Song B. Radiomic Machine Learning and External Validation Based on 3.0 T mpMRI for Prediction of Intraductal Carcinoma of Prostate With Different Proportion. Front Oncol 2022; 12:934291. [PMID: 35837116 PMCID: PMC9274129 DOI: 10.3389/fonc.2022.934291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 05/24/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose To assess the association of radiomics features based on multiparametric MRI (mpMRI) with the proportion of intraductal carcinoma of prostate (IDC-P) and validate the predictive models. Materials and Methods We retrospectively included pre-treatment MR images of prostate cancer (PCa) with IDC components of high proportion (≥10%, hpIDC-P), low proportion (<10%, lpIDC-P), and pure acinar adenocarcinoma (PAC) from our institution for training and internal validation and cooperated cohort for external validation. Normalized images of T2WI, diffusion weighted imaging (DWI) and apparent diffusion coefficient (ADC) map, and dynamic contrast enhanced (DCE) sequences were used for radiomics modeling. The clinical model was built based on serum total prostate specific antigen (tPSA) and Gleason score (GS), and the integrated model was the combination of Rad-score and clinicopathological data. The discrimination ability was assessed by area under the receiver operating characteristic curve (ROC-AUC) in the internal and external validation sets and compared by DeLong test. Results Overall, 97 patients with hpIDC-P, 87 lpIDC-P, and 78 PAC were included for training and internal validation, and 11, 16, and 19 patients for external validation. The integrated model for predicting hpIDC-P got the best ROC-AUC of 0.88 (95%CI = 0.83-0.93) in internal and 0.86 (95%CI = 0.72-1.0) in external validation, which both outperformed clinical models (AUC=0.78, 95% CI = 0.72-0.85, AUC=0.69, 95% CI = 0.5-0.85, respectively) based solely on GS, and the radiomics model (AUC=0.85, 95% CI = 0.79-0.91) was slightly inferior to the integrated model and better than the clinical model in internal dataset. The integrated model for predicting lpIDC-P outperformed both radiomics and clinical models in the internal dataset, while slightly inferior to the integrated model for predicting hpIDC-P. Conclusions Radiomics signature improved differentiation of both hpIDC-P and lpIDC-P versus PAC when compared with the clinical model based on Gleason score, and was validated in an external cohort.
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Affiliation(s)
- Ling Yang
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Zhengyan Li
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Xu Liang
- Department of Radiology, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Jingxu Xu
- Department of Research Collaboration, R&D center, Beijing Deepwise & League of PHD Technology Co., Ltd., Beijing, China
| | - Yusen Cai
- Department of Research Collaboration, R&D center, Beijing Deepwise & League of PHD Technology Co., Ltd., Beijing, China
| | - Chencui Huang
- Department of Research Collaboration, R&D center, Beijing Deepwise & League of PHD Technology Co., Ltd., Beijing, China
| | - Mengni Zhang
- Department of Pathology, West China Hospital of Sichuan University, Chengdu, China
| | - Jin Yao
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Bin Song
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
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Gordetsky JB, Schaffer K, Hurley PJ. Current conundrums with cribriform prostate cancer. Histopathology 2022; 80:1038-1040. [PMID: 35592932 DOI: 10.1111/his.14665] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 04/12/2022] [Accepted: 04/13/2022] [Indexed: 12/15/2022]
Affiliation(s)
- Jennifer B Gordetsky
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Urology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kerry Schaffer
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.,Vanderbilt-Ingram Cancer Center, Nashville, TN, USA
| | - Paula J Hurley
- Department of Urology, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.,Vanderbilt-Ingram Cancer Center, Nashville, TN, USA
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12
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Rijstenberg LL, Hansum T, Kweldam CF, Kümmerlin IP, Remmers S, Roobol MJ, van Leenders GJLH. Large and small cribriform architecture have similar adverse clinical outcome on prostate cancer biopsies. Histopathology 2022; 80:1041-1049. [PMID: 35384019 PMCID: PMC9321809 DOI: 10.1111/his.14658] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 03/08/2022] [Accepted: 03/31/2022] [Indexed: 11/29/2022]
Abstract
Aims Invasive cribriform and intraductal carcinoma (IDC) are associated with adverse outcome in prostate cancer patients, with the large cribriform pattern having the worst outcome in radical prostatectomies. Our objective was to determine the impact of the large and small cribriform patterns in prostate cancer biopsies. Methods and results Pathological revision was carried out on biopsies of 1887 patients from the European Randomised Study of Screening for Prostate Cancer. The large cribriform pattern was defined as having at least twice the size of adjacent benign glands. The median follow‐up time was 13.4 years. Hazard ratios for metastasis‐free survival (MFS) and disease‐specific survival (DSS) were calculated using Cox proportional hazards regression. Any cribriform pattern was found in 280 of 1887 men: 1.1% IDC in grade group (GG) 1, 18.2% in GG2, 57.1% in GG3, 55.4% in GG4 and 59.3% in GG5; the large cribriform pattern was present in 0, 0.5, 9.8, 18.1 and 17.3%, respectively. In multivariable analyses, small and large cribriform patterns were both (P < 0.005) associated with worse MFS [small: hazard ratio (HR) = 3.04, 95% confidence interval (CI) = 1.93–4.78; large: HR = 3.17, 95% CI = 1.68–5.99] and DSS (small: HR = 4.07, 95% CI = 2.51–6.62; large: HR = 4.13, 95% CI = 2.14–7.98). Patients with the large cribriform pattern did not have worse MFS (P = 0.77) or DSS (P = 0.96) than those with the small cribriform pattern. Conclusions Both small and large cribriform patterns are associated with worse MFS and DSS in prostate cancer biopsies. Patients with the large cribriform pattern on biopsy have a similar adverse outcome as those with the small cribriform pattern.
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Affiliation(s)
- L Lucia Rijstenberg
- Department of Pathology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - Tim Hansum
- Department of Pathology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - Charlotte F Kweldam
- Department of Pathology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands.,Department of Pathology, Maasstad Hospital, Rotterdam, the Netherlands
| | - Intan P Kümmerlin
- Department of Pathology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - Sebastiaan Remmers
- Department of Urology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - Monique J Roobol
- Department of Urology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
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13
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Surintrspanont J, Zhou M. Prostate Pathology: What is New in the 2022 WHO Classification of Urinary and Male Genital Tumors? Pathologica 2022; 115:41-56. [PMID: 36645399 DOI: 10.32074/1591-951x-822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 10/28/2022] [Indexed: 01/17/2023] Open
Abstract
In 2022, after a six-year interval, the International Agency for Research on Cancer (IARC) has published the 5th edition of the WHO Classification of Urinary and Male Genital Tumors, which provides a comprehensive update on tumor classification of the genitourinary system. This review article focuses on prostate carcinoma and underscores changes in the prostate chapter as well as those made across the entire series of the 5th edition of WHO Blue Books. Although no major alterations were made to this chapter, some of the most notable updates include restructure of contents and introduction of a new format; standardization of mitotic counts, genomic nomenclatures, and units of length; refined definition for the terms "variant", "subtype", and "histologic pattern"; reclassification of prostatic intraepithelial neoplasia (PIN)-like adenocarcinoma as a subtype of prostatic acinar adenocarcinoma; and recognition of treatment-related neuroendocrine prostatic carcinoma as a distinct tumor type. Evolving and unsettled issues related to grading of intraductal carcinoma of the prostate and reporting of tertiary Gleason pattern, the definition and prognostic significance of cribriform growth pattern, and molecular pathology of prostate cancer will also be covered in this review.
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Affiliation(s)
- Jerasit Surintrspanont
- Department of Pathology, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand.,Department of Pathology and Laboratory Medicine, Tufts Medical Center, Boston, MA, USA
| | - Ming Zhou
- Department of Pathology and Laboratory Medicine, Tufts Medical Center, Boston, MA, USA
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14
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Ma C, Downes M, Jain R, Ientilucci M, Fleshner N, Perlis N, van der Kwast T. Prevalence of adverse pathology features in grade group 2 prostatectomy specimens with syn- or metachronous metastatic disease. Prostate 2022; 82:345-351. [PMID: 34878188 DOI: 10.1002/pros.24279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 11/03/2021] [Accepted: 11/22/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND To validate the importance of recently established adverse histopathology features (cribriform pattern and intraductal carcinoma) as contra-indication for deferred treatment of Gleason score 7 (3 + 4) (grade group [GG] 2) prostate cancer, we investigated their frequency in GG2 radical prostatectomies with syn- or metachronous metastatic disease. METHODS GG2 prostatectomy specimens of patients with concomitant lymph node metastasis or distant metastasis at follow-up were identified in a clinical database of a tertiary care center and their pathology was reviewed for pathological stage, lymphovascular invasion, Gleason grade 4 subpatterns, presence of tertiary grade 5, and ductal adenocarcinoma histology. A control group of 99 GG2 prostatectomy specimens who had no metastatic disease (controls) was reviewed for the same adverse pathological features. RESULTS Of 1860 GG2 prostatectomy specimens (operated between 2002 and 2020), 45 (2.4%) had concurrent regional lymph node metastases or distant metastases at follow-up. Pathological stage distribution of cases and controls was 24% and 79% pT2, 42% and 15% pT3a, 33% and 6.1% pT3b -T4, respectively (p < 0.001). Eleven of 45 cases (24%) had ≤10% Gleason grade 4 component. Cribriform pattern or intraductal carcinoma was present in 84% of cases versus 34% of controls (p < 0.001), tertiary grade 5 in 16% of cases versus 5% controls (p = 0.05) and ductal adenocarcinoma in 16% of cases versus 2% of controls (p = 0.004). Among the seven cases without cribriform or intraductal carcinoma, two displayed ductal adenocarcinoma features. CONCLUSIONS Well-established unfavorable histopathologic features (intraductal and cribriform pattern carcinoma, ductal adenocarcinoma) are represented in about 90% of GG2 prostate cancers with local or distant metastatic disease and are much less common (38%) in those without metastatic disease. Strikingly, about 25% of GG2 prostatectomy cases with metastatic disease had an organ-confined disease and/or a small percentage of Gleason grade 4 pattern. This further emphasizes the relative importance of these adverse histopathological features (cribriform, intraductal, and ductal adenocarcinoma) rather than percentage Gleason grade 4 as contra-indicator of deferred treatment for patients with GG2 prostate cancer.
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Affiliation(s)
- Christopher Ma
- Department of Pathology, Laboratory Medicine Program, Anatomic Pathology, University Health Network, Toronto, Ontario, Canada
| | - Michelle Downes
- Department of Pathology, Laboratory Medicine and Molecular Diagnostics, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Rahi Jain
- Department of Biostatistics, Princess Margaret Hospital, Toronto, Ontario, Canada
| | - Marc Ientilucci
- Division of Urology, Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Neil Fleshner
- Division of Urology, Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Nathan Perlis
- Division of Urology, Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Theodorus van der Kwast
- Department of Pathology, Laboratory Medicine Program, Anatomic Pathology, University Health Network, Toronto, Ontario, Canada
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15
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Kang M, Lee H, Byeon SJ, Kwon GY, Jeon SS. Genomic Features and Clinical Implications of Intraductal Carcinoma of the Prostate. Int J Mol Sci 2021; 22:13125. [PMID: 34884926 DOI: 10.3390/ijms222313125] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/02/2021] [Accepted: 12/02/2021] [Indexed: 01/29/2023] Open
Abstract
Intraductal carcinoma of the prostate (IDC-P) is a rare and unique form of aggressive prostate carcinoma, which is characterized by an expansile proliferation of malignant prostatic epithelial cells within prostatic ducts or acini and the preservation of basal cell layers around the involved glands. The vast majority of IDC-P tumors result from adjacent high-grade invasive cancer via the retrograde spreading of tumor cells into normal prostatic ducts or acini. A subset of IDC-P tumors is rarely derived from the de novo intraductal proliferation of premalignant cells. The presence of IDC-P in biopsy or surgical specimens is significantly associated with aggressive pathologic features, such as high Gleason grade, large tumor volume, and advanced tumor stage, and with poor clinical courses, including earlier biochemical recurrence, distant metastasis, and worse survival outcomes. These architectural and behavioral features of IDC-P may be driven by specific molecular properties. Notably, IDC-P possesses distinct genomic profiles, including higher rates of TMPRSS2–ERG gene fusions and PTEN loss, increased percentage of genomic instability, and higher prevalence of germline BRCA2 mutations. Considering that IDC-P tumors are usually resistant to conventional therapies for prostate cancer, further studies should be performed to develop optimal therapeutic strategies based on distinct genomic features, such as treatment with immune checkpoint blockades or poly (adenosine diphosphate–ribose) polymerase inhibitors for patients harboring increased genomic instability or BRCA2 mutations, as well as genetic counseling with genetic testing. Patient-derived xenografts and tumor organoid models can be the promising in vitro platforms for investigating the molecular features of IDC-P tumor.
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16
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Spieker AJ, Gordetsky JB, Maris AS, Dehan LM, Denney JE, Arnold Egloff SA, Scarpato K, Barocas DA, Giannico GA. PTEN expression and morphological patterns in prostatic adenocarcinoma. Histopathology 2021; 79:1061-1071. [PMID: 34324714 PMCID: PMC10792610 DOI: 10.1111/his.14531] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 07/25/2021] [Accepted: 07/27/2021] [Indexed: 11/27/2022]
Abstract
AIMS Cribriform morphology, which includes intraductal carcinoma (IDCP) and invasive cribriform carcinoma, is an indicator of poor prognosis in prostate cancer. Phosphatase and tensin homologue (PTEN) loss is a predictor of adverse clinical outcomes. The association between PTEN expression and morphological patterns of prostate cancer is unclear. METHODS AND RESULTS We explored the association between PTEN expression by immunohistochemistry, Gleason pattern 4 morphologies, IDCP and biochemical recurrence (BCR) in 163 radical prostatectomy specimens. IDCP was delineated from invasive cribriform carcinoma by p63 positive immunohistochemical staining in basal cells. Combined invasive cribriform carcinoma and IDCP were associated with a higher cumulative incidence of BCR [hazard ratio (HR) = 5.06; 2.21, 11.6, P < 0.001]. When including PTEN loss in the analysis, invasive cribriform carcinoma remained predictive of BCR (HR = 3.72; 1.75, 7.94, P = 0.001), while PTEN loss within invasive cribriform carcinoma did not. Glomeruloid morphology was associated with lower odds of cancer stage pT3 and lower cumulative incidence of BCR (HR = 0.27; 0.088, 0.796, P = 0.018), while PTEN loss within glomeruloid morphology was associated with a higher cumulative incidence of BCR (HR = 4.07; 1.04, 15.9, P = 0.043). CONCLUSIONS PTEN loss within glomeruloid pattern was associated with BCR. The presence of any cribriform pattern was associated with BCR, despite PTEN loss not significantly associated with invasive cribriform carcinoma. We speculate that other drivers independent from PTEN loss may contribute to poor prognostic features in cribriform carcinoma.
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Affiliation(s)
- Andrew J Spieker
- Department of Biostatistics, Vanderbilt University, Nashville, TN, USA
| | - Jennifer B Gordetsky
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Urology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Alexander S Maris
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Lauren M Dehan
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - James E Denney
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Shanna A Arnold Egloff
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
- Sarah Cannon Cancer Center, Nashville, TN, USA
| | - Kristen Scarpato
- Department of Urology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Daniel A Barocas
- Department of Urology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Giovanna A Giannico
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
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17
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Tzelepi V, Grypari IM, Logotheti S, Kontogiannis S, Kallidonis P, Melachrinou M, Zolota V. Contemporary Grading of Prostate Cancer: The Impact of Grading Criteria and the Significance of the Amount of Intraductal Carcinoma. Cancers (Basel) 2021; 13:5454. [PMID: 34771617 DOI: 10.3390/cancers13215454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 10/24/2021] [Accepted: 10/28/2021] [Indexed: 01/02/2023] Open
Abstract
(1) Background: Prognostic grade group (PGG) is an important prognostic parameter in prostate cancer that guides therapeutic decisions. The cribriform pattern and intraductal carcinoma (IDC) are two histological patterns, that have additional prognostic significance. However, discrepancies exist regarding the handling of IDC according to the guidelines published by two international genitourinary pathology societies. Furthermore, whether, in addition to its presence, the amount of IDC is also of importance has not been studied before. Lastly, the handling of tertiary patterns has also been a matter of debate in the literature. (2) Methods: A total of 129 prostatectomy cases were retrieved and a detailed histopathologic analysis was performed. (3) Results: Two cases (1.6%) upgraded their PGG, when IDC was incorporated in the grading system. The presence and the amount of IDC, as well as the presence of cribriform carcinoma were associated with adverse pathologic characteristics. Interestingly, in six cases (4.7%) there was a difference in PGG when using the different guidelines regarding the handling of tertiary patterns. In total, 6.2% of the cases would be assigned a different grade depending on the guidelines followed. (4) Conclusions: These findings highlight a potential area of confusion among pathologists and clinicians and underscore the need for a consensus grading system.
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18
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Bishop JA. IDK what's next for IDC: The unfolding saga of intraductal carcinoma of salivary glands. Cancer Cytopathol 2021; 129:926-927. [PMID: 34597463 DOI: 10.1002/cncy.22508] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 08/13/2021] [Indexed: 12/12/2022]
Affiliation(s)
- Justin A Bishop
- Department of Pathology, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas
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19
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Viswanathan K, Sadow PM, Maleki Z, Nishino M, Baloch ZW, Abbott TE, Rao R, Faquin WC. Cytomorphologic features of intraductal salivary gland carcinoma: A multi-institutional study of 13 FNA cases with histologic, molecular, and clinical correlations. Cancer Cytopathol 2021; 129:928-946. [PMID: 34597458 DOI: 10.1002/cncy.22504] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/10/2021] [Accepted: 05/18/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Intraductal carcinoma of the salivary gland (IDC) is a rare cancer with potential actionable targets, including RET fusions. Histologic and molecular features of IDC were recently reported, but cytomorphologic data are limited. In the largest multi-institutional fine-needle aspiration (FNA) series, the authors describe the cytomorphologic features of 13 IDC cases with available clinical, radiologic, histopathologic, and molecular data. METHODS The cases included 13 FNAs for 9 low-grade (LG) IDCs and 4 high-grade (HG) IDCs with corresponding histopathology and available molecular, imaging, and clinical data. Smears and liquid-based preparations available for 12 FNAs were semiquantitatively scored for key cytomorphologic findings and correlated with the corresponding resection. RESULTS LG IDC FNAs showed a cellular, biphasic population of large, atypical ductal cells with mildly pleomorphic nuclei in a clean background and a minor population of small, uniform myoepithelial cells. In contrast, all HG IDC FNAs showed predominantly ductal cells with marked nuclear pleomorphism, coarse chromatin, and necrosis. With the Milan system, most LG and HG IDC FNAs were classified as either salivary gland neoplasms of uncertain malignant potential (54%) or malignant (31%). Immunohistochemistry showed ductal epithelial reactivity with mammaglobin, androgen receptor, and S100, whereas myoepithelial cells were positive for p63 and/or calponin. Among cases with next-generation sequencing, 4 LG IDCs showed NCOA4-RET gene fusions, whereas an HG IDC showed HRAS and PIK3CA mutations. CONCLUSIONS The cytomorphology of IDC overlaps with other benign and malignant salivary gland neoplasms. Immunohistochemistry limits the differential diagnosis, but definitive classification requires molecular analysis. A diagnosis of IDC has potential implications for patient management.
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Affiliation(s)
- Kartik Viswanathan
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Peter M Sadow
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Zahra Maleki
- Department of Pathology, Johns Hopkins Hospital, Baltimore, Maryland
| | - Michiya Nishino
- Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
| | - Zubair W Baloch
- Department of Pathology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Todd E Abbott
- Department of Pathology, Newton-Wellesley Hospital, Newton, Massachusetts.,Tufts University School of Medicine, Boston, Massachusetts
| | - Rema Rao
- Department of Pathology, Medical Center/Albert Einstein College of Medicine, Bronx, New York
| | - William C Faquin
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
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20
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Bishop JA, Nakaguro M, Whaley RD, Ogura K, Imai H, Laklouk I, Faquin WC, Sadow PM, Gagan J, Nagao T. Oncocytic intraductal carcinoma of salivary glands: a distinct variant with TRIM33-RET fusions and BRAF V600E mutations. Histopathology 2021; 79:338-346. [PMID: 33135196 DOI: 10.1111/his.14296] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 10/26/2020] [Accepted: 10/30/2020] [Indexed: 12/11/2022]
Abstract
AIMS Salivary gland intraductal carcinoma (IDC) is a complex ductal neoplasm surrounded by a layer of myoepithelial cells. Recent insights have shown that there are three different types: intercalated duct-like, with frequent NCOA4-RET fusions; apocrine, with salivary duct carcinoma-like mutations; and mixed intercalated duct-like/apocrine, with RET fusions, including TRIM27-RET. In addition, an oncocytic IDC has been described, but it remains unclear whether it represents a fourth variant or simply oncocytic metaplasia of another IDC type. Our aim was to more completely characterize oncocytic IDC. METHODS AND RESULTS Six IDCs with oncocytic changes were retrieved from the authors' archives, from three men and three women ranging in age from 45 to 75 years (mean, 63 years). Five arose in the parotid gland, with one in an accessory parotid gland. Four patients with follow-up were free of disease after 1-23 months. Several immunostains (S100, mammaglobin, androgen receptor, and p63/p40) and molecular tools (RNA sequencing, RET fluorescence in-situ hybridisation, BRAF V600E VE1 immunohistochemistry, and Sanger sequencing) were applied. Histologically, the tumours were variably cystic with solid intracystic nodules often difficult to recognise as intraductal. In all, tumour ducts were positive for S100 and mammaglobin, negative for androgen receptor, and completely surrounded by myoepithelial cells positive for p63/p40. Molecular analysis revealed TRIM33-RET in two of six cases, NCOA4-RET in one of six cases, and BRAF V600E in two of six cases. One case had no identifiable alterations. CONCLUSIONS Oncocytic IDC shares similarities with intercalated duct-like IDC. Although additional verification is needed, the oncocytic variant appears to be sufficiently unique to be now regarded as the fourth distinct subtype of IDC. Because of its indolent nature, oncocytic IDC should be distinguished from histological mimics.
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Affiliation(s)
- Justin A Bishop
- Department of Pathology, UT Southwestern Medical Center, Dallas, TX, USA
| | - Masato Nakaguro
- Departments of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan.,Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Rumeal D Whaley
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Kanako Ogura
- Department of Diagnostic Pathology, Juntendo University Nerima Hospital, Tokyo, Japan
| | - Hiroshi Imai
- Pathology Division, Mie University Hospital, Tsu, Japan
| | - Israa Laklouk
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - William C Faquin
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Peter M Sadow
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jeffrey Gagan
- Department of Pathology, UT Southwestern Medical Center, Dallas, TX, USA
| | - Toshitaka Nagao
- Department of Anatomical Pathology, Tokyo Medical University, Tokyo, Japan
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21
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Dongre A, Dongre T, Deshmukh M, Agrawal S, Kanchankar N. Pulmonary sarcoidosis masquerading as metastatic breast cancer: a case report. Pan Afr Med J 2021; 38:245. [PMID: 34104293 PMCID: PMC8164421 DOI: 10.11604/pamj.2021.38.245.28421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 02/24/2021] [Indexed: 11/19/2022] Open
Abstract
Pulmonary lesions on imaging are presumed to be metastatic lesions in patients with breast cancer. Here, we report an interesting case of a 63-year-old lady with breast carcinoma showing pulmonary lesions on imaging suggestive of pulmonary metastases. Detailed evaluation of pulmonary lesions confirmed the presence of co-existing pulmonary sarcoidosis. Modern diagnostic methods like 18-flurodeoxyglucose positron emission tomography (18-FDG PET) are unable to clearly differentiate metastatic disease from granulomatous diseases like sarcoidosis. Thus, histological confirmation is needed for accurate staging and determining response to treatment and rarely, in non-responders, detecting any co-existing disease. This case emphasizes the need for detailed histopathological examination of lymph nodes in patients with non-responsive disease or recurrent disease despite adequate chemotherapy.
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Affiliation(s)
- Amol Dongre
- Department of Medical Oncology, Alexis Multispecialty Hospital, Nagpur, Maharashtra, India
| | - Trupti Dongre
- Department of Pathology, Narendra Kumar Prasadrao (NKP) Salve Institute of Medical Sciences and Research Centre and Lata Mangeshkar Hospital, Nagpur, Maharashtra, India
| | - Mahesh Deshmukh
- Department of Pathology, Alexis Multispecialty Hospital, Nagpur, Maharashtra, India
| | - Suraj Agrawal
- Department of Surgical Oncology, Alexis Multispecialty Hospital, Nagpur, Maharashtra, India
| | - Niraj Kanchankar
- Department of Radiology, Alexis Multispecialty Hospital, Nagpur, Maharashtra, India
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22
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Hollemans E, Verhoef EI, Bangma CH, Rietbergen J, Roobol MJ, Helleman J, van Leenders GJLH. Clinical outcome comparison of Grade Group 1 and Grade Group 2 prostate cancer with and without cribriform architecture at the time of radical prostatectomy. Histopathology 2021; 76:755-762. [PMID: 31944367 PMCID: PMC7216977 DOI: 10.1111/his.14064] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Revised: 12/08/2019] [Accepted: 01/13/2020] [Indexed: 11/30/2022]
Abstract
Aims Invasive cribriform and intraductal carcinoma are associated with aggressive disease in Grade Group 2 (GG2) prostate cancer patients. However, the characteristics and clinical outcome of patients with GG2 prostate cancer without cribriform architecture (GG2−) as compared with those with Grade Group 1 (GG1) prostate cancer are unknown. The aim of this study was to investigate the clinical and pathological characteristics of GG1 and GG2− prostate cancer in radical prostatectomy specimens. Methods and results We reviewed 835 radical prostatectomy specimens for Grade Group, pT stage, surgical margin status, and the presence of cribriform architecture. Biochemical recurrence‐free survival and metastasis were used as clinical outcomes. GG1 prostate cancer was seen in 207 patients, and GG2 prostate cancer was seen in 420 patients, of whom 228 (54%) showed cribriform architecture (GG2+) and 192 (46%) did not. GG2− patients had higher prostate‐specific antigen levels (9.4 ng/ml versus 7.0 ng/ml; P < 0.001), more often had extraprostatic extension (36% versus 11%; P < 0.001) and had more positive surgical margins (27% versus 17%; P = 0.01) than GG1 patients. GG2− patients had shorter biochemical recurrence‐free survival (hazard ratio 2.7, 95% confidence interval 1.4–4.9; P = 0.002) than GG1 patients. Lymph node and distant metastasis were observed neither in GG2− nor in GG1 patients, but occurred in 22 of 228 (10%) GG2+ patients. Conclusion In conclusion, patients with GG2− prostate cancer at radical prostatectomy have more advanced disease and shorter biochemical recurrence‐free survival than those with GG1 prostate cancer, but both groups have a very low risk of developing metastasis.
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Affiliation(s)
- Eva Hollemans
- Department of Pathology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - Esther I Verhoef
- Department of Pathology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - Chris H Bangma
- Department of Urology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - John Rietbergen
- Department of Urology, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands
| | - Monique J Roobol
- Department of Urology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - Jozien Helleman
- Department of Urology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
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23
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Abstract
Intraductal carcinoma of the prostate (IDC-P) is a diagnostic entity characterized by architecturally or cytologically malignant-appearing prostatic glandular epithelium confined to prostatic ducts. Despite its apparent in situ nature, this lesion is associated with aggressive prostatic adenocarcinoma and is a predictor for poor prognosis when identified on biopsy or radical prostatectomy. This review discusses diagnosis, clinical features, histogenesis, and management of IDC-P, as well as current research and controversies surrounding this entity.
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Taverna C, Baněčková M, Lorenzon M, Palomba A, Franchi A, Skalova A, Agaimy A. MUC4 is a valuable marker for distinguishing secretory carcinoma of the salivary glands from its mimics. Histopathology 2020; 79:315-324. [PMID: 32931030 DOI: 10.1111/his.14251] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 08/21/2020] [Accepted: 09/09/2020] [Indexed: 12/12/2022]
Abstract
AIMS Secretory carcinoma (SC) (synonym: mammary analogue secretory carcinoma) is a low-grade salivary gland tumour that occurs in both major and minor salivary glands. SC is known for its wide morphological, architectural and immunohistochemical spectrum, which overlaps with those of several salivary gland neoplasms, including acinic cell carcinoma (AciCC) and intercalated duct-type intraductal carcinoma (IDC) in major salivary glands, and polymorphous adenocarcinoma (PAC) in minor salivary glands. These tumours share with SC some morphological features and SOX10 immunoreactivity; also, with the exception of AciCC, they all coexpress S100 and mammaglobin. METHODS AND RESULTS We compared MUC4 and mammaglobin expression in 125 salivary gland carcinomas (54 genetically confirmed SCs, 20 AciCCs, 21 PACs, and 30 IDCs) to evaluate the potential of these two markers to differentiate these entities. Moderate to strong diffuse MUC4 positivity was detected in 49 SCs (90.7%), as compared with none of the IDCs and PACs. In contrast, mammaglobin was frequently expressed in SCs (30 of 36 cases; 83.3%), IDCs (24/28; 85.7%), and PACs (7/19; 36.8%). Two of three high-grade SCs lost MUC4 expression in the high-grade tumour component. No significant correlation was found between MUC4 expression and the fusion variant in SC (ETV6-NTRK versus non-ETV6-NTRK). CONCLUSION The results of our study identify MUC4 as a sensitive (90.7%) and specific (100%) marker for SC, with high positive (100%) and negative (93.4%) predictive values. Thus, MUC4 may be used as a surrogate for SC in limited biopsy material and in cases with equivocal morphology.
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Affiliation(s)
- Cecilia Taverna
- Institute of Pathology, Friedrich-Alexander-University Erlangen-Nürnberg, University Hospital, Erlangen, Germany.,Department of Laboratory Medicine, Unit of Anatomical Pathology, Pisa University Hospital, Pisa, Italy
| | - Martina Baněčková
- Department of Pathology, Faculty of Medicine in Plzen, Charles University, Plzen, Czech Republic
| | - Monica Lorenzon
- The Molecular Foundry, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Annarita Palomba
- Unit of Histopathology and Molecular Diagnostics, Careggi University Hospital, Florence, Italy
| | - Alessandro Franchi
- Department of Translational Research, School of Medicine, University of Pisa, Pisa, Italy
| | - Alena Skalova
- Department of Pathology, Faculty of Medicine in Plzen, Charles University, Plzen, Czech Republic
| | - Abbas Agaimy
- Institute of Pathology, Friedrich-Alexander-University Erlangen-Nürnberg, University Hospital, Erlangen, Germany
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25
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Varma M, Epstein JI. Head to head: should the intraductal component of invasive prostate cancer be graded? Histopathology 2020; 78:231-239. [PMID: 32692448 DOI: 10.1111/his.14216] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 07/13/2020] [Accepted: 07/16/2020] [Indexed: 12/11/2022]
Abstract
The reporting of intraductal carcinoma of the prostate (IDCP) is controversial, with conflicting recommendations having recently been published by the International Society of Urological Pathology (ISUP) and the Genitourinary Pathology Society (GUPS). Both recommend that isolated (pure) IDCP should not be graded. However, the ISUP recommends incorporating the IDCP component of invasive prostate cancer in the Gleason score, whereas the GUPS recommends reporting IDCP as a comment, independently of the Gleason score. The arguments for and against incorporating the IDCP component of invasive prostate cancer in the Gleason score are discussed in detail.
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Affiliation(s)
- Murali Varma
- Cardiff University, Cardiff, UK.,University Hospital of Wales, Cardiff, UK
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Rijstenberg LL, Hansum T, Hollemans E, Kweldam CF, Kümmerlin IP, Bangma CH, van der Kwast TH, Roobol MJ, van Leenders GJLH. Intraductal carcinoma has a minimal impact on Grade Group assignment in prostate cancer biopsy and radical prostatectomy specimens. Histopathology 2020; 77:742-748. [PMID: 32542746 PMCID: PMC7692905 DOI: 10.1111/his.14179] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/05/2020] [Accepted: 06/10/2020] [Indexed: 11/30/2022]
Abstract
AIMS Intraductal carcinoma (IDC) is an adverse histopathological parameter for prostate cancer outcome, but is not incorporated in current tumour grading. To account for its dismal prognosis and to omit basal cell immunohistochemistry, it has been proposed to grade IDC on the basis of its underlying architectural pattern. The aim of this study was to determine the impact of IDC grade assignment on prostate cancer biopsy and radical prostatectomy tumour grading. METHODS AND RESULTS A cohort of 1031 prostate cancer biopsies and 835 radical prostatectomies were assigned a Grade Group according to the 2014 International Society of Urological Pathology guidelines, without incorporation of IDC in grading. Tumour grading was compared with a Grade Group in which IDC was graded on the basis of its underlying architecture. Of 1031 biopsies, 139 (13.5%) showed IDC. Grade assignment of IDC led to a Grade Group change in 17 (1.6%) cases: four of 486 (0.8%) Grade Group 1 cases were reclassified as Grade Group 2, nine of 375 (2.4%) Grade Group 2 cases were reclassified as Grade Group 3, and four of 58 (6.9%) Grade Group 4 cases were reclassified as Grade Group 5. IDC was observed in 213 of 835 (25.5%) radical prostatectomies, and its grading led to a change in tumour grade in five of 835 (0.6%) patients, with upgrading in two of 207 (1.0%) patients with Grade Group 1 cancer, in two of 420 (0.5%) patients with Grade Group 2 cancer, and in one of 50 (2%) patients with Grade Group 4 cancer. CONCLUSION IDC grade assignment led to a Grade Group change in 1.6% of prostate biopsy specimens and in 0.6% of radical prostatectomy specimens. Although the inclusion of IDC in or the exclusion of IDC from the Grade Group might affect decision-making in individual patients, it has a minimal impact on overall prostate cancer management.
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Affiliation(s)
- L Lucia Rijstenberg
- Department of Pathology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - Tim Hansum
- Department of Pathology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - Eva Hollemans
- Department of Pathology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - Charlotte F Kweldam
- Department of Pathology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.,Department of Pathology, Maasstad Hospital, Rotterdam, The Netherlands
| | - Intan P Kümmerlin
- Department of Pathology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - Chris H Bangma
- Department of Urology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | | | - Monique J Roobol
- Department of Urology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
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Chen-Maxwell D, Prendeville S. Grading of prostate cancer: the impact of including intraductal carcinoma on the overall Grade Group assigned in diagnostic biopsies. Histopathology 2020; 77:503-507. [PMID: 32358793 DOI: 10.1111/his.14132] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 04/28/2020] [Indexed: 01/23/2023]
Abstract
AIMS The Gleason score/Grade Group (GrG) is a key parameter for clinical decision-making in prostate cancer. The World Health Organization currently recommends that intraductal carcinoma of the prostate (IDCP) should not be factored into the GrG; however, grading of IDCP is controversial, with variability among genitourinary pathologists. The aim of this study was to evaluate the impact of grading of the IDCP component on the final GrG in prostate biopsies. METHODS AND RESULTS The study included 123 prostate biopsies (12 cores +/- additional MRI-targeted cores) with GrG1-GrG4 invasive carcinoma and IDCP. All cases were graded by a genitourinary pathologist using two different methods: (i) grading of invasive carcinoma only; and (ii) grading of both invasive carcinoma and IDCP. The overall GrG, excluding the IDCP component, was GrG1 in 3% (n = 4) of cases, GrG2 in 37% (n = 45), GrG3 in 52% (n = 64), and GrG4 in 8% (n = 10). When the IDCP component was included in grading, the overall GrG changed in 28 cases (23%). The GrG increased by one grade in 15 of 28 cases (54%), and by two or more grades in 13 of 28 cases (46%). Upgrading was due to comedonecrosis (39%, 11/28), solid growth (4%, 1/28), or an increased proportion of Gleason grade 4 (57%, 16/28). CONCLUSIONS Although the GrG was unchanged in the majority of cases, grading of IDCP altered the final GrG in a significant minority of biopsies in this series, and often by more than one grade, which may have important implications for risk categorisation of individual patients. These findings highlight the need for consensus on grading of IDCP in routine practice, and the optimal method of incorporating IDCP into clinical risk models for patient management.
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Affiliation(s)
| | - Susan Prendeville
- Department of Histopathology, Cork University Hospital, Cork, Ireland
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Palicelli A. What do we know about the cytological features of pure intraductal carcinomas of the salivary glands? Cytopathology 2020; 31:185-192. [PMID: 31749241 DOI: 10.1111/cyt.12790] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 11/05/2019] [Accepted: 11/10/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Intraductal carcinomas (IDCs) are rare, poorly characterised salivary gland tumours. The cytological features of IDCs are even less known. In this paper, a systematic literature review of pure IDCs (without stromal invasion, not associated with other histotypes) of low-grade (LG-IDCs) and high-grade (HG-IDCs) was performed. METHODS The bibliographic research included multiple databases (PubMed, Scopus, Web of Science). Mild-moderate nuclear atypia favoured LG-IDCs, severe atypia favoured HG-IDCs. RESULTS Preoperative fine-needle aspiration cytology (FNAC) was performed in 13/94 published cases (14%): 10 parotid; two oral; one submandibular. All the cases were histologically LG-IDCs, except two parotid IDCs. FNAC results included: negative for malignancy (three of 13 cases, 23%); tumour of uncertain malignant potential (seven of 13, 54%); malignancy (three of 13, 23%). The ductal component was identified in two cases; mucoepidermoid carcinoma was suggested in two additional cases. The grade was underestimated on FNAC evaluation in one HG-IDC as focal high-grade features were present on subsequent histological examination. The cases diagnosed as malignant tumours or describing intermediate atypia resulted in LG-IDCs on subsequent histology. Occasional mitoses were described only in one HG-IDC; this feature may have not been considered in the remaining published cases. CONCLUSIONS FNAC and clinico-pathological correlation are important aids for clinicians and pathologists. FNAC could assist surgery even if an accurate diagnosis is sometimes impossible. Discrepancy in grading the nuclear atypia between the FNAC material and the resected specimen can occur, sometimes being unavoidable. Further studies are needed to better characterise this rare tumour.
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Affiliation(s)
- Andrea Palicelli
- Pathology Unit, Azienda Unità Sanitaria Locale-IRCCS, Reggio Emilia, Italy
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29
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Yamamoto A, Kato M, Hattori K, Naito Y, Tochigi K, Sano T, Kawanishi H, Ishikawa T, Yuba T, Hattori R, Gotoh M, Tsuzuki T. Propensity score-matched comparison of docetaxel and androgen receptor axis-targeted agents in patients with castration-resistant intraductal carcinoma of the prostate. BJU Int 2019; 125:702-708. [PMID: 31833179 DOI: 10.1111/bju.14970] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To evaluate the efficacy of docetaxel and androgen receptor axis-targeted (ARAT) agents in patients with castration-resistant prostate cancer (CRPC) with intraductal carcinoma of the prostate (IDC-P) using a propensity score-matched analysis. PATIENTS AND METHODS We retrospectively identified 309 patients with CRPC from February 2007 to February 2016 at Nagoya University and its affiliated hospitals. All patients received initial androgen-deprivation therapy (ADT). After progression to CRPC, they received docetaxel or ARAT (abiraterone or enzalutamide) as first-line life-prolonging therapy. Docetaxel (70-75 mg/m2 ) every 3 weeks vs enzalutamide (160 mg) once daily orally or abiraterone (1 g) once daily plus prednisone (5 mg) twice daily orally was administered. The primary outcome of interest was overall survival (OS) from the time of CRPC diagnosis. A propensity score analysis with a 1:1 ratio using an optimal matching algorithm was used to adjust for confounding factors. RESULTS Overall, 234 patients were analysed. Propensity score-matching identified 85 patients in each group. There were no significant differences in patient characteristics between the groups. The median OS in the docetaxel group was 38.2 vs 58.3 months in the ARAT group (P = 0.03). For patients with IDC-P, OS was significantly longer in the ARAT group than the docetaxel group (P = 0.01), and there was no significant difference in each group, as in patients without IDC-P (P = 0.67). A multivariate analysis showed that the presence of IDC-P, duration of primary ADT, visceral metastasis, and administration of ARAT as the first-line treatment for CRPC were independent prognostic factors for OS. CONCLUSION Administration of ARAT as the first-line treatment for CRPC may prolong OS more than that of docetaxel, especially in patients with IDC-P.
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Affiliation(s)
- Akiyuki Yamamoto
- Department of Urology, Toyohashi Municipal Hospital, Toyohashi, Japan
| | - Masashi Kato
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kyosuke Hattori
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yushi Naito
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kosuke Tochigi
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tomoyasu Sano
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hideji Kawanishi
- Department of Urology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan
| | | | - Takuma Yuba
- Department of Urology, Kariya Toyota General Hospital, Kariya, Japan
| | - Ryohei Hattori
- Department of Urology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan
| | - Momokazu Gotoh
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Toyonori Tsuzuki
- Department of Surgical Pathology, Aichi Medical University Hospital, Nagakute, Japan
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Montironi R, Cimadamore A, Gasparrini S, Mazzucchelli R, Santoni M, Massari F, Cheng L, Lopez-Beltran A, Scarpelli M. Prostate cancer with cribriform morphology: diagnosis, aggressiveness, molecular pathology and possible relationships with intraductal carcinoma. Expert Rev Anticancer Ther 2018; 18:685-693. [PMID: 29699428 DOI: 10.1080/14737140.2018.1469406] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
INTRODUCTION The Gleason grading system is one of the most important prognostic factors in prostate cancer (PCa). From the 2005 to the 2014 conference organized by the International Society of Urological Pathology (ISUP), the histological criteria for the Gleason patterns were improved, resulting in the shrinkage of the Gleason pattern (GP) 3 and expansion of the GP 4. Areas Covered: Cribriform, fused, ill-defined and glomeruloid glands are part of the morphologic spectrum of the current GP 4. Cribriform, derived from the Latin word cribrum (i.e. sieve), was introduced by Gleason to describe glands composed of a solid sheet with perforations or lumina. Cribriform morphology has a worse prognosis compared with the other, non-cribriform, GP4 morphologies. A practical implication is that a cribriform growth precludes a patient from selecting an active surveillance (AS) protocol. Expert commentary: The presence of these four growth patterns should be incorporated into the current Grade Group (GG) system. Enhancing our understanding of cribriform tumor behavior will lead to correctly identifying and treating those patients that will die because of PCa, while sparing treatment in those who do not require it.
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Affiliation(s)
- Rodolfo Montironi
- a Section of Pathological Anatomy , Polytechnic University of the Marche Region, School of Medicine, United Hospitals , Ancona , Italy
| | - Alessia Cimadamore
- a Section of Pathological Anatomy , Polytechnic University of the Marche Region, School of Medicine, United Hospitals , Ancona , Italy
| | - Silvia Gasparrini
- a Section of Pathological Anatomy , Polytechnic University of the Marche Region, School of Medicine, United Hospitals , Ancona , Italy
| | - Roberta Mazzucchelli
- a Section of Pathological Anatomy , Polytechnic University of the Marche Region, School of Medicine, United Hospitals , Ancona , Italy
| | | | - Francesco Massari
- c Division of Oncology , S. Orsola-Malpighi Hospital , Bologna , Italy
| | - Liang Cheng
- d Department of Pathology and Laboratory Medicine , Indiana University School of Medicine , Indianapolis , USA
| | | | - Marina Scarpelli
- a Section of Pathological Anatomy , Polytechnic University of the Marche Region, School of Medicine, United Hospitals , Ancona , Italy
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Murata Y, Tatsugami K, Yoshikawa M, Hamaguchi M, Yamada S, Hayakawa Y, Ueda K, Momosaki S, Sakamoto N. Predictive factors of biochemical recurrence after radical prostatectomy for high-risk prostate cancer. Int J Urol 2018; 25:284-289. [PMID: 29315854 DOI: 10.1111/iju.13514] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 11/13/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To identify risk factors of biochemical recurrence after radical prostatectomy in high-risk patients. METHODS A total of 191 high-risk prostate cancer patients according to the D'Amico classification treated with radical prostatectomy at a single institution between April 2000 and December 2013 were enrolled. The pathological evaluation including intraductal carcinoma of prostate was reassessed, and the clinical and pathological risk factors of biochemical recurrence were analyzed. RESULTS The median follow up after radical prostatectomy was 49 months. The 5-year biochemical recurrence-free survival rate after radical prostatectomy in high-risk prostate cancer patients was 41.6%. Initial prostate-specific antigen, pathological Gleason score, seminal vesicle invasion, extraprostatic extension and intraductal carcinoma of the prostate were significantly associated with biochemical recurrence-free survival. The 5-year biochemical recurrence-free survival rates in patients with zero, one, two and three of these risk factors were 92.9%, 70.7%, 38.3% and 28.8%, respectively. In patients with four or more factors, the biochemical recurrence-free survival rate was 6.1% after 18 months. CONCLUSIONS In D'Amico high-risk patients treated with radical prostatectomy, risk factors for biochemical recurrence can be identified. Patients with fewer risk factors have longer biochemical recurrence-free survival, even among these high-risk cases.
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Affiliation(s)
- Yukiko Murata
- Department of Urology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Katsunori Tatsugami
- Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, , Japan
| | - Masahiro Yoshikawa
- Department of Urology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Masumitsu Hamaguchi
- Department of Urology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Shigetomo Yamada
- Department of Urology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Yusuke Hayakawa
- Department of Urology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Kouhei Ueda
- Department of Urology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Seiya Momosaki
- Department of Pathology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Naotaka Sakamoto
- Department of Urology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan.,Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
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Saeter T, Vlatkovic L, Waaler G, Servoll E, Nesland JM, Axcrona K, Axcrona U. Intraductal Carcinoma of the Prostate on Diagnostic Needle Biopsy Predicts Prostate Cancer Mortality: A Population-Based Study. Prostate 2017; 77:859-865. [PMID: 28240424 DOI: 10.1002/pros.23326] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 02/07/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND Intraductal carcinoma of the prostate (IDC-P) is a distinct histopathologic feature associated with high-grade, advanced prostate cancer. Although studies have shown that IDC-P is a predictor of progression following surgical or radiation treatment for prostate cancer, there are sparse data regarding IDC-P on diagnostic needle biopsy as a prognosticator of prostate cancer mortality. MATERIALS AND METHODS This was a population-based study of all prostate cancer patients diagnosed using needle biopsy and without evidence of systemic disease between 1991 and 1999 within a defined geographic region of Norway. Patients were identified by cross-referencing the Norwegian Cancer Registry. Of 318 eligible patients, 283 had biopsy specimens available for central pathology review. Clinical data were obtained from medical charts. We examined whether IDC-P on diagnostic needle biopsy was associated with adverse clinicopathological features and prostate cancer mortality. RESULTS Patients with IDC-P on diagnostic needle biopsy had a more advanced stage and a higher Gleason score compared to patients without IDC-P. IDC-P was also associated with an intensively reactive stroma. The 10-year prostate cancer-specific survival was 69% for patients with IDC-P on diagnostic needle biopsy and 89% for patients without IDC-P (Log rank P-value < 0.005). The presence of IDC-P on diagnostic needle biopsy remained an independent predictor of prostate cancer mortality after adjustments for clinical prognostic factors and treatment. After adjustment for the newly implemented Grade Group system of prostate cancer, IDC-P showed a strong tendency toward statistical significance. However, IDC-P did not remain a statistically significant predictor in the multivariable analysis. CONCLUSION IDC-P on diagnostic needle biopsy is an indicator of prostate cancer with a high risk of mortality. Accordingly, a diagnosis of IDC-P on needle biopsy should be reported and considered a feature of high-risk prostate cancer. Moreover, the association between IDC-P and reactive stroma provides evidence in support of the idea that stromal factors facilitate carcinoma invasion to the prostatic acini and ducts. Prostate 77:859-865, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Thorstein Saeter
- Medical Faculty, University of Oslo, Oslo, Norway
- Department of Surgery, Sørlandet Hospital Arendal, Arendal, Norway
| | - Ljiljana Vlatkovic
- Department of Pathology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Gudmund Waaler
- Department of Surgery, Sørlandet Hospital Arendal, Arendal, Norway
| | - Einar Servoll
- Department of Surgery, Sørlandet Hospital Arendal, Arendal, Norway
| | - Jahn M Nesland
- Medical Faculty, University of Oslo, Oslo, Norway
- Department of Pathology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Karol Axcrona
- Department of Urology, Akershus University Hospital, Lørenskog, Norway
| | - Ulrika Axcrona
- Department of Pathology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
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Tang B, Han CT, Gan HL, Zhang GM, Zhang CZ, Yang WY, Shen Y, Zhu Y, Ye DW. Smoking increased the risk of prostate cancer with grade group ≥ 4 and intraductal carcinoma in a prospective biopsy cohort. Prostate 2017; 77:984-989. [PMID: 28422303 DOI: 10.1002/pros.23354] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 03/17/2017] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To investigate the association between smoking and different prostate cancer (PCa) pathological subtypes incidence in Chinese men. PATIENTS AND METHODS We prospectively included 1795 patients who underwent prostate biopsies in one tertiary center between March 2013 and April 2016. Clinical data and biopsy outcomes were collected. Logistic regression was used to evaluate the association between cigarette smoking and PCa incidence. RESULTS A total of 737 men, 480 men and 58 men were diagnosed with PCa, high-grade PCa (HGPCa, grade group ≥ 4 as accepted by the 2014 ISUP) and intraductal carcinoma of the prostate (IDC-P), respectively. Current smokers had a significantly higher risk of HGPCa than never smokers (OR = 1.89, 95%CI: 1.44-2.48). No such association was observed for low-grade disease and cigarette smoking (OR = 0.84, 95%CI: 0.61-1.16). In a sub-analysis, men who had smoked longer than 30 years had a higher risk of HGPCa, compared with men who had smoked fewer than 30 years (OR = 1.50, 95%CI: 1.09-2.06). Current smokers were more likely to develop IDC-P than never smokers (OR = 2.29, 95%CI: 1.14-4.59). CONCLUSION Among men in this Chinese biopsy cohort, current smoking was associated with highly malignant PCa incidence, such as HGPCa and IDC-P. The duration of smoking may be associated with HGPCa.
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Affiliation(s)
- Bo Tang
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical Colleague, Fudan University, Shanghai, China
| | - Cheng-Tao Han
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical Colleague, Fudan University, Shanghai, China
| | - Hua-Lei Gan
- Department of Oncology, Shanghai Medical Colleague, Fudan University, Shanghai, China
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Gui-Ming Zhang
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical Colleague, Fudan University, Shanghai, China
| | - Cui-Zhu Zhang
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical Colleague, Fudan University, Shanghai, China
| | - Wei-Yi Yang
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical Colleague, Fudan University, Shanghai, China
| | - Ying Shen
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical Colleague, Fudan University, Shanghai, China
| | - Yao Zhu
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical Colleague, Fudan University, Shanghai, China
| | - Ding-Wei Ye
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical Colleague, Fudan University, Shanghai, China
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Olkhov-Mitsel E, Siadat F, Kron K, Liu L, Savio AJ, Trachtenberg J, Fleshner N, van der Kwast T, Bapat B. Distinct DNA methylation alterations are associated with cribriform architecture and intraductal carcinoma in Gleason pattern 4 prostate tumors. Oncol Lett 2017; 14:390-396. [PMID: 28693181 DOI: 10.3892/ol.2017.6140] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 02/23/2017] [Indexed: 12/20/2022] Open
Abstract
The aim of the present study was to explore DNA methylation aberrations in association with cribriform architecture and intraductal carcinoma (IDC) of the prostate, as there is robust evidence that these morphological features are associated with aggressive disease and have significant clinical implications. Herein, the associations of a panel of seven known prognostic DNA methylation biomarkers with cribriform and IDC features were examined in a series of 91 Gleason pattern (GP) 4 tumors derived from Gleason score 7 radical prostatectomies. Gene specific DNA methylation was compared between cribriform and/or IDC positive vs. negative cases, and in association with clinicopathological features, using Chi square and Mann-Whitney U tests. DNA methylation of the adenomatous polyposis coli, Ras association domain family member 1 and T-box 15 genes was significantly elevated in GP4 tumors with cribriform and/or IDC features compared with negative cases (P=0.045, P=0.007 and P=0.013, respectively). To the best of our knowledge, this provides the first evidence for an association between cribriform and/or IDC and methylation biomarkers, and warrants further investigation of additional DNA methylation events in association with various architectural patterns in prostate cancer.
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Affiliation(s)
- Ekaterina Olkhov-Mitsel
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON M5T3L9, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S1A1, Canada
| | - Farshid Siadat
- Department of Anatomical Pathology, Royal Alexandra Hospital, Edmonton, AB T5H3V9, Canada
| | - Ken Kron
- Ontario Cancer Institute, Princess Margaret Cancer Center, University Health Network, Toronto, ON M5G0A3, Canada
| | - Liyang Liu
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON M5T3L9, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S1A1, Canada
| | - Andrea J Savio
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON M5T3L9, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S1A1, Canada
| | - John Trachtenberg
- Division of Urology, Department of Surgical Oncology, University Health Network, University of Toronto, Toronto, ON M5G2M9, Canada
| | - Neil Fleshner
- Division of Urology, Department of Surgical Oncology, University Health Network, University of Toronto, Toronto, ON M5G2M9, Canada
| | - Theodorus van der Kwast
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S1A1, Canada.,Department of Pathology, University Health Network, Toronto, ON M5G2C4, Canada
| | - Bharati Bapat
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON M5T3L9, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S1A1, Canada.,Department of Pathology, University Health Network, Toronto, ON M5G2C4, Canada
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Xiao GQ, Unger PD. Focal Signet Ring Cell High-Grade Prostatic Intraepithelial Neoplasia on Needle Biopsy. Int J Surg Pathol 2017; 25:344-347. [PMID: 28058847 DOI: 10.1177/1066896916685835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Signet ring cell prostatic intraepithelial neoplasia is a rare speculated variant of high-grade prostatic intraepithelial neoplasia (HGPIN). Here, we present a free-standing and isolated signet ring cell HGPIN that was not associated with invasive carcinoma on needle biopsy and demonstrated the existence of this type of HGPIN variant. The differentiation between HGPIN and intraductal carcinoma of prostate is also discussed.
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Affiliation(s)
- Guang-Qian Xiao
- 1 Keck Medical Center of the University of Southern California, Los Angeles, CA, USA
| | - Pamela D Unger
- 2 Lenox Hill Hospital-Northwell Health, New York, NY, USA
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36
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Acosta AM, Sharif A, Groth JV, Kajdacsy-Balla A. Ductal Spread Versus High-Grade Prostatic Intraepithelial Neoplasia: A Diagnostic Pitfall. Int J Surg Pathol 2016; 24:718-719. [PMID: 27605089 DOI: 10.1177/1066896916668639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Ductal spread (DS) of acinar adenocarcinoma of the prostate can lead to an incomplete replacement of the benign epithelium by cancer cells, resulting in a lesion that can be indistinguishable from high-grade prostatic intraepithelial neoplasia (HGPIN). Kovi and colleagues demonstrated 30 years ago that there is a significant association between the presence of DS and local extent of invasive adenocarcinoma, making the distinction between DS and HGPIN clinically relevant. However, despite the existence of certain morphologic features that are suggestive of DS, a definitive differentiation between the aforementioned lesions cannot always be attained.
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Semeraro M, Adam J, Stoll G, Louvet E, Chaba K, Poirier-Colame V, Sauvat A, Senovilla L, Vacchelli E, Bloy N, Humeau J, Buque A, Kepp O, Zitvogel L, André F, Mathieu MC, Delaloge S, Kroemer G. The ratio of CD8 +/FOXP3 T lymphocytes infiltrating breast tissues predicts the relapse of ductal carcinoma in situ. Oncoimmunology 2016; 5:e1218106. [PMID: 27853639 DOI: 10.1080/2162402x.2016.1218106] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 07/20/2016] [Accepted: 07/22/2016] [Indexed: 01/21/2023] Open
Abstract
In a series of 248 tumor samples obtained from image-guided biopsies from patients diagnosed with ductal carcinoma in situ of the breast, we attempted to identify biomarkers that predict microinfiltration at definitive surgery or relapse during follow-up. For this, we used immunohistochemical methods, followed by automated image analyses, to measure the mean diameter of nuclei (which correlates with ploidy), the phosphorylation of eukaryotic initiation factor 2α (eIF2α, which reflects endoplasmic reticulum stress) as well as the density and ratio of CD8+ cytotoxic T lymphocytes and FOXP3+ regulatory T cells. The median nuclear diameter of malignant cells correlated with eIF2α phosphorylation (in cancerous tissue), which in turn correlated with the density of the CD8+ infiltrate and the CD8+/FOXP3 ratio (both in cancerous and the adjacent non-cancerous parenchyma). Neither microinfiltration nor lymph node involvement was associated with the probability of relapse. Both correlated positively with the CD8+/FOXP3 ratio in the malignant area. In contrast, relapse was associated with a paucity of the CD8+ infiltrate as well as an unfavorable CD8+/FOXP3 ratio, both in malignant and non-malignant parenchyma. The combined analysis of the CD8+/FOXP3 ratio in cancerous and non-cancerous tissues revealed a significant impact of their interaction on the probability of relapse, but not on the presence of microinfiltration or lymph node metastasis. Altogether, these results support the idea of an immunosurveillance system that determines the risk of relapse in ductal carcinoma in situ of the breast.
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Affiliation(s)
- Michaela Semeraro
- Gustave Roussy Cancer Campus, Villejuif, France; INSERM, U1138, Paris, France; Equipe 11 labellisée par la Ligue Nationale contre le Cancer, Center de Recherche des Cordeliers, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Université Pierre et Marie Curie, Paris, France
| | - Julien Adam
- Department of Medical Biology and Pathology, Gustave Roussy Cancer Campus, Villejuif, France; Module de Développement en Pathologie Expérimentale-INSERM U981, Gustave-Roussy Cancer Campus, Villejuif, France
| | - Gautier Stoll
- Gustave Roussy Cancer Campus, Villejuif, France; INSERM, U1138, Paris, France; Equipe 11 labellisée par la Ligue Nationale contre le Cancer, Center de Recherche des Cordeliers, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Université Pierre et Marie Curie, Paris, France
| | - Emilie Louvet
- Module de Développement en Pathologie Expérimentale-INSERM U981, Gustave-Roussy Cancer Campus , Villejuif, France
| | - Kariman Chaba
- Gustave Roussy Cancer Campus, Villejuif, France; INSERM, U1138, Paris, France; Equipe 11 labellisée par la Ligue Nationale contre le Cancer, Center de Recherche des Cordeliers, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Université Pierre et Marie Curie, Paris, France
| | - Vichnou Poirier-Colame
- Faculté de Médecine, Université Paris-Saclay, Kremlin-Bicêtre, France; Center of Clinical Investigations in Biotherapies of Cancer (CICBT) 507, Villejuif, France; Department of Immuno-Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - Allan Sauvat
- Gustave Roussy Cancer Campus, Villejuif, France; INSERM, U1138, Paris, France; Equipe 11 labellisée par la Ligue Nationale contre le Cancer, Center de Recherche des Cordeliers, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Université Pierre et Marie Curie, Paris, France
| | - Laura Senovilla
- Gustave Roussy Cancer Campus, Villejuif, France; INSERM, U1138, Paris, France; Equipe 11 labellisée par la Ligue Nationale contre le Cancer, Center de Recherche des Cordeliers, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Université Pierre et Marie Curie, Paris, France
| | - Erika Vacchelli
- Gustave Roussy Cancer Campus, Villejuif, France; INSERM, U1138, Paris, France; Equipe 11 labellisée par la Ligue Nationale contre le Cancer, Center de Recherche des Cordeliers, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Université Pierre et Marie Curie, Paris, France
| | - Norma Bloy
- Gustave Roussy Cancer Campus, Villejuif, France; INSERM, U1138, Paris, France; Equipe 11 labellisée par la Ligue Nationale contre le Cancer, Center de Recherche des Cordeliers, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Université Pierre et Marie Curie, Paris, France; Faculté de Médecine, Université Paris-Saclay, Kremlin-Bicêtre, France
| | - Juliette Humeau
- Gustave Roussy Cancer Campus, Villejuif, France; INSERM, U1138, Paris, France; Equipe 11 labellisée par la Ligue Nationale contre le Cancer, Center de Recherche des Cordeliers, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Université Pierre et Marie Curie, Paris, France; Faculté de Médecine, Université Paris-Saclay, Kremlin-Bicêtre, France
| | - Aitziber Buque
- Gustave Roussy Cancer Campus, Villejuif, France; INSERM, U1138, Paris, France; Equipe 11 labellisée par la Ligue Nationale contre le Cancer, Center de Recherche des Cordeliers, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Université Pierre et Marie Curie, Paris, France
| | - Oliver Kepp
- Gustave Roussy Cancer Campus, Villejuif, France; INSERM, U1138, Paris, France; Equipe 11 labellisée par la Ligue Nationale contre le Cancer, Center de Recherche des Cordeliers, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Université Pierre et Marie Curie, Paris, France
| | - Laurence Zitvogel
- Faculté de Médecine, Université Paris-Saclay, Kremlin-Bicêtre, France; Center of Clinical Investigations in Biotherapies of Cancer (CICBT) 507, Villejuif, France; Department of Immuno-Oncology, Gustave Roussy Cancer Campus, Villejuif, France; INSERM, U1015, Villejuif, France
| | - Fabrice André
- INSERM, U981 "Identification of molecular predictors and new targets for cancer treatment", Villejuif, France; Department of Medical Oncology and Breast Cancer Group, Gustave Roussy Cancer Campus, Villejuif, France
| | - Marie-Christine Mathieu
- Department of Medical Biology and Pathology, Gustave Roussy Cancer Campus , Villejuif, France
| | - Suzette Delaloge
- Department of Medical Oncology and Breast Cancer Group, Gustave Roussy Cancer Campus , Villejuif, France
| | - Guido Kroemer
- Gustave Roussy Cancer Campus, Villejuif, France; INSERM, U1138, Paris, France; Equipe 11 labellisée par la Ligue Nationale contre le Cancer, Center de Recherche des Cordeliers, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Université Pierre et Marie Curie, Paris, France; Pôle de Biologie, Hôpital Européen Georges Pompidou, AP-HP, Paris, France; Karolinska Institute, Department of Women's and Children's Health, Karolinska University Hospital, Stockholm, Sweden
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Clauser P, Marino MA, Baltzer PAT, Bazzocchi M, Zuiani C. Management of atypical lobular hyperplasia, atypical ductal hyperplasia, and lobular carcinoma in situ. Expert Rev Anticancer Ther 2016; 16:335-46. [PMID: 26780850 DOI: 10.1586/14737140.2016.1143362] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Atypical hyperplasia and lobular carcinoma in situ are rare proliferative breast lesions, growing inside ducts and terminal ducto-lobular units. They represent a marker of increased risk for breast cancer and a non-obligate precursor of malignancy. Evidence available on diagnosis and management is scarce. They are frequently found incidentally associated with other lesions, but can be visible through mammography, ultrasound or magnetic resonance. Due to the risk of underestimation, surgical excision is often performed. The analysis of imaging and histopathological characteristics could help identifying low-risk cases, for which surgery is not necessary. Chemopreventive agents can be used for risk reduction. Careful imaging follow up is mandatory; the role of breast MRI as screening modality is under discussion.
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Affiliation(s)
- Paola Clauser
- a Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging , Medical University of Vienna , Vienna , Austria
| | - Maria A Marino
- a Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging , Medical University of Vienna , Vienna , Austria
| | - Pascal A T Baltzer
- a Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging , Medical University of Vienna , Vienna , Austria
| | - Massimo Bazzocchi
- b Institute of Diagnostic Radiology , Department of Medical and Biological Sciences, University of Udine , Udine , Italy
| | - Chiara Zuiani
- b Institute of Diagnostic Radiology , Department of Medical and Biological Sciences, University of Udine , Udine , Italy
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39
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Berger-Höger B, Liethmann K, Mühlhauser I, Haastert B, Steckelberg A. Informed shared decision-making supported by decision coaches for women with ductal carcinoma in situ: study protocol for a cluster randomized controlled trial. Trials 2015; 16:452. [PMID: 26458964 PMCID: PMC4603943 DOI: 10.1186/s13063-015-0991-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 09/30/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Women with breast cancer want to participate in treatment decision-making. Guidelines have confirmed the right of informed shared decision-making. However, previous research has shown that the implementation of informed shared decision-making is suboptimal for reasons of limited resources of physicians, power imbalances between patients and physicians and missing evidence-based patient information. We developed an informed shared decision-making program for women with primary ductal carcinoma in situ (DCIS). The program provides decision coaching for women by specialized nurses and aims at supporting involvement in decision-making and informed choices. In this trial, the informed shared decision-making program will be evaluated in breast care centers. METHODS/DESIGN A cluster randomized controlled trial will be conducted to compare the informed shared decision-making program with standard care. The program comprises an evidence-based patient decision aid and training of physicians (2 hours) and specialized breast care and oncology nurses (4 days) in informed shared decision-making. Sixteen certified breast care centers will be included, with 192 women with primary DCIS being recruited. Primary outcome is the extent of patients' involvement in shared decision-making as assessed by the MAPPIN-Odyad (Multifocal approach to the 'sharing' in shared decision-making: observer instrument dyad). Secondary endpoints include the sub-measures of the MAPPIN-inventory (MAPPIN-Onurse, MAPPIN-Ophysician, MAPPIN-Opatient, MAPPIN-Qnurse, MAPPIN-Qpatient and MAPPIN-Qphysician), informed choice, decisional conflict and the duration of encounters. It is expected that decision coaching and the provision of evidence-based patient decision aids will increase patients' involvement in decision-making with informed choices and reduce decisional conflicts and duration of physician encounters. Furthermore, an accompanying process evaluation will be conducted. DISCUSSION To our knowledge, this is the first study investigating the implementation of decision coaches in German breast care centers. TRIAL REGISTRATION Current Controlled Trials ISRCTN46305518 , date of registration: 5 June 2015.
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Affiliation(s)
- Birte Berger-Höger
- University of Hamburg, MIN-Faculty, Unit of Health Sciences and Education, Martin-Luther-King-Platz 6, D-20146, Hamburg, Germany.
| | - Katrin Liethmann
- University of Hamburg, MIN-Faculty, Unit of Health Sciences and Education, Martin-Luther-King-Platz 6, D-20146, Hamburg, Germany.
| | - Ingrid Mühlhauser
- University of Hamburg, MIN-Faculty, Unit of Health Sciences and Education, Martin-Luther-King-Platz 6, D-20146, Hamburg, Germany.
| | - Burkhard Haastert
- mediStatistica Neuenrade, Lambertusweg 1b, D-58809, Neuenrade, Germany.
| | - Anke Steckelberg
- University of Hamburg, MIN-Faculty, Unit of Health Sciences and Education, Martin-Luther-King-Platz 6, D-20146, Hamburg, Germany.
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40
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Siadat F, Sykes J, Zlotta AR, Aldaoud N, Egawa S, Pushkar D, Kuk C, Bristow RG, Montironi R, van der Kwast T. Not all gleason pattern 4 prostate cancers are created equal: A study of latent prostatic carcinomas in a cystoprostatectomy and autopsy series. Prostate 2015; 75:1277-84. [PMID: 25963383 DOI: 10.1002/pros.23009] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 03/27/2015] [Indexed: 11/10/2022]
Abstract
BACKGROUND The Gleason grading system represents the cornerstone of the management of prostate cancer. Gleason grade 4 (G4) is a heterogeneous set of architectural patterns, each of which may reflect a distinct prognostic value. METHODS We determined the prevalence of the various G4 architectural patterns and intraductal carcinoma (IDC) in latent prostate cancer in contemporary Russian (n = 220) and Japanese (n = 100) autopsy prostates and in cystoprostatectomy (CP) specimens (n = 248) collected in Italy. We studied the association of each G4 pattern with extraprostatic extension (EPE) and tumor volume to gain insight into their natural history. Presence of IDC and nine architectural features of Gleason grade 4 and 5 cancer were recorded. RESULTS The prevalence of Gleason score ≥ 7 PC was higher in the autopsy series (11%) compared to the CP series (6.5%, P = 0.04). The prevalence of IDC and carcinoma with a cribriform architecture was 2.2% and 3.4% in the autopsy series and 0.8% and 3.6% in the cystoprostatectomy series, respectively. In multivariable analysis, cribriform architecture was significantly associated with increased tumor volume (P < 0.001) and EPE (OR:11.48, 95%CI:2.30-57.16, P = 0.003). IDC was also significantly associated with EPE (OR:10.08, 95%CI:1.58-64.28, P = 0.014). Small fused glands had a strong negative association with EPE in the autopsy series (OR:0.06, 95%CI:0.01-0.58, P = 0.015). DISCUSSION Our study revealed that in latent prostate cancer both cribriform architecture and IDC are uniquely associated with poor pathological outcome features. In contrast, Gleason score 7 (3 + 4) cancers with small-fused gland pattern might possibly include some prostate cancers with a more indolent biology.
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Affiliation(s)
- Farshid Siadat
- Department of Anatomical Pathology, Royal Alexandra Hospital, Edmonton, Alberta, Canada
| | - Jenna Sykes
- Biostatistics, Princess Margaret Cancer Center, Toronto, Ontario, Canada
| | - Alexandre R Zlotta
- Department of Surgery, Division of Urology, Mount Sinai Hospital and Princess Margaret Cancer Center, University Health Network, Toronto, Ontario, Canada
| | - Najla Aldaoud
- Department of Pathology and Microbiology, Jordan University of Science and Technology, Irbid, Jordan
| | - Shin Egawa
- Department of Urology, Jikei University School of Medicine, Tokyo, Japan
| | - Dmitry Pushkar
- Department of Urology, University of Moscow, Moscow, Russia
| | - Cynthia Kuk
- Department of Surgery, Division of Urology, Mount Sinai Hospital and Princess Margaret Cancer Center, University Health Network, Toronto, Ontario, Canada
| | - Robert G Bristow
- Department of Radiation Oncology, Princess Margaret Cancer Center, University Health Network, Toronto, Ontario, Canada
| | - Rodolfo Montironi
- Institute of Pathological Anatomy, Polytechnic University of the Marche Region, School of Medicine, United Hospitals, Ancona, Italy
| | - Theodorus van der Kwast
- Department of Laboratory Medicine and Pathology, University Health Network, Toronto, Ontario, Canada
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Zhong X, Shen H, Yuan Y. Intraductal carcinoma and carcinosarcoma with bone metastases presenting in one breast: A case report. Oncol Lett 2014; 8:2678-2680. [PMID: 25364449 PMCID: PMC4214474 DOI: 10.3892/ol.2014.2573] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Accepted: 09/09/2014] [Indexed: 11/05/2022] Open
Abstract
Carcinosarcoma of the breast is an extremely rare and clinically aggressive tumor possessing carcinomatous components and malignant mesenchymal elements, with few cases reported in the literature. The prognosis of breast carcinosarcoma is poor when compared with more common types of breast cancer, such as ductal or lobular carcinoma. Furthermore, carcinosarcoma presents a diagnostic and therapeutic challenge due to the diversity in histology pattern and the lack of consensus regarding diagnostic criteria and effective systemic management. A 51-year-old female presented to the Department of Medical Oncology of the Second Affiliated Hospital of Zhejiang University (Hangzhou, China) with the complaint of lumbago and physical examination revealed a small mass in the right breast near the areola. Mammography and magnetic resonance imaging revealed two small masses, which were <1 cm in diameter. Positron emission tomography/computed tomography showed a maximum standardized uptake volume of 3.46 for one soft tissue nodule and multiple bones that were exhibiting radioactive enhancement. The patient was diagnosed with a breast carcinosarcoma with bone metastases and breast intraductal carcinoma. The response to chemotherapy was poor and the patient succumbed to the disease within one month of diagnosis.
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Affiliation(s)
- Xian Zhong
- Department of Medical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P.R. China ; Department of Medical Oncology, Hangzhou Binjiang Hospital, Hangzhou, Zhejiang 310052, P.R. China
| | - Hong Shen
- Department of Medical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P.R. China
| | - Ying Yuan
- Department of Medical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P.R. China
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Yang J, Zhu J, He K, Zhao LY, Liu LY, Song TS, Huang C. Proteomic Profiling of Invasive Ductal Carcinoma (IDC) using Magnetic Beads-based Serum Fractionation and MALDI-TOF MS. J Clin Lab Anal 2014; 29:321-7. [PMID: 25130542 DOI: 10.1002/jcla.21773] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Accepted: 04/03/2014] [Indexed: 11/11/2022] Open
Abstract
AIM To reveal the serum proteomic profiling of intraductal carcinoma (IDC) patients in China, establish a serum proteome fractionation technique for choosing magnetic beads for proteomic analysis in breast cancer research; and identify differentially expressed peptides (m/z; P < 0.0001) as potential biomarkers of early IDCs. METHODS We used two different kinds of magnetic beads (magnetic bead-based weak cation exchange chromatography (MB-WCX) and immobilized metal ion affinity chromatography (MB-IMAC-Cu)) to analyze 32 patients with early stage (stages I-II) IDC and 32 healthy control serum samples for proteomic profiling by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) analysis. The mass spectra, analyzed using ClinProTools software, distinguished between IDC patients and healthy individuals based on k-nearest neighbor genetic algorithm. RESULTS The serum samples purified in the MB-WCX group provided better proteomic patterns than the MB-IMAC-Cu group. The samples purified by MB-WCX had better average peak numbers, higher peak intensities, and better capturing ability of low abundance proteins or peptides in serum samples. In addition, the MB-WCX and MB-IMAC-Cu purification methods, followed MALDI-TOF MS identification and use of ClinProTools software accurately distinguished patients with early stage IDC from healthy individuals. CONCLUSION Serum proteomic profiling by MALDI-TOF MS is a novel potential tool for the clinical diagnosis of patients with IDC in China.
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Affiliation(s)
- Juan Yang
- Department of Genetics and Molecular Biology, Medical School of Xi'an Jiaotong University / Key Laboratory of Environment and Disease-Related Gene, Ministry of Education, Xi'an, China
| | - Jiang Zhu
- Department of Mastopathy, Shaanxi Provincial Tumor Hospital, Xi'an, China
| | - Kang He
- Department of Genetics and Molecular Biology, Medical School of Xi'an Jiaotong University / Key Laboratory of Environment and Disease-Related Gene, Ministry of Education, Xi'an, China
| | - Ling-Yu Zhao
- Department of Genetics and Molecular Biology, Medical School of Xi'an Jiaotong University / Key Laboratory of Environment and Disease-Related Gene, Ministry of Education, Xi'an, China
| | - Li-Ying Liu
- Department of Genetics and Molecular Biology, Medical School of Xi'an Jiaotong University / Key Laboratory of Environment and Disease-Related Gene, Ministry of Education, Xi'an, China
| | - Tu-Sheng Song
- Department of Genetics and Molecular Biology, Medical School of Xi'an Jiaotong University / Key Laboratory of Environment and Disease-Related Gene, Ministry of Education, Xi'an, China
| | - Chen Huang
- Department of Genetics and Molecular Biology, Medical School of Xi'an Jiaotong University / Key Laboratory of Environment and Disease-Related Gene, Ministry of Education, Xi'an, China
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Cundell DS, Rowe E, Oxley J. Intraductal spread of prostate cancer into the seminal vesicles. Histopathology 2013:n/a-n/a. [PMID: 26538515 DOI: 10.1111/j.1365-2559.2013.12351.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Revised: 12/16/2013] [Accepted: 12/19/2013] [Indexed: 11/26/2022]
Abstract
We read with interest the significance of the different types of seminal vesicle invasion described in the recent paper by Kristiansen et al 1 The three types of invasion of the seminal vesicle are well recognised, but there is a much rarer method of invasion, that is by intraductal cancer spreading up into the seminal vesicles via the ejaculatory ducts. This method has been reported in a single case report 2 but was not seen in the series by Kristiansen 1. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- David S Cundell
- Department of Cellular Pathology, Southmead Hospital, North Bristol NHS Trust, Bristol
| | - Edward Rowe
- Department of Urology, Southmead Hospital, North Bristol NHS Trust, Bristol
| | - Jon Oxley
- Department of Cellular Pathology, Southmead Hospital, North Bristol NHS Trust, Bristol
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44
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Watts K, Li J, Magi-Galluzzi C, Zhou M. Incidence and clinicopathological characteristics of intraductal carcinoma detected in prostate biopsies: a prospective cohort study. Histopathology 2013; 63:574-9. [PMID: 23931616 DOI: 10.1111/his.12198] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Accepted: 05/24/2013] [Indexed: 11/28/2022]
Abstract
AIMS Intraductal carcinoma of the prostate (IDC-P) is a distinct clinicopathological entity and is associated with aggressive, high-grade and high-volume prostate carcinoma (PCa). The incidence, clinicopathological characteristics and prognostic significance of IDC-P have not been reported in prostate biopsies (PBx) that surgical pathologists encounter in their daily practice. METHODS AND RESULTS In 1176 prospectively collected PBx, 33 IDC-P cases were identified (2.8%). The mean age of patients with IDC-P was 65 (range 46-79) years and mean serum prostate-specific antigen was 16.2 (range 0.4-105.6) ng/ml. Three (0.26%) IDC-P cases did not have a concomitant invasive PCa. Of 30 cases with concomitant invasive PCa, Gleason score was 7 in 16 (53.3%), 8 in four (13.3%) and 9 in 10 (33.3%) cases. The mean number of biopsy cores involved by PCa was 7.2 (range 1-14). Nine patients were treated with radical prostatectomy. Seminal vesicle invasion was found in four of nine (44%) cases, significantly higher than the risk of 12% predicted by Partin Tables (P = 0.016). CONCLUSIONS This is the first prospective study that has investigated the incidence and prognostic significance of IDC-P diagnosed in PBx encountered in daily practice. It is critical for surgical pathologists to diagnose and report IDC-P in PBx.
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Affiliation(s)
- Katherine Watts
- Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland, OH, USA
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45
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Mochizuki K, Kondo T, Oishi N, Kawasaki T, Nakazawa T, Yamane T, Katoh R. Immature squamous metaplasia (focal atypical epithelial hyperplasia) of the pancreatic duct-immunohistochemical distinction from intraductal carcinoma. Histopathology 2013; 63:343-50. [PMID: 23829443 DOI: 10.1111/his.12180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Accepted: 05/01/2013] [Indexed: 11/28/2022]
Abstract
AIMS Immature squamous metaplasia of the pancreatic duct (ISMPD) can be difficult to differentiate from an intraductal carcinoma of the pancreas (ICP), and little is known about the pathological nature of ISMPD. The aim of this study was to analyse 20 ISMPD and 10 ICP tissue samples. METHODS AND RESULTS ISMPD shares some characteristics with ICP. Seven of 20 ISMPD samples were covered by a layer of pancreatic duct epithelium, whereas this was not seen in the ICP samples. Immunohistochemistry of ISMPD revealed positivity for p63 (100%), cytokeratin 5/6 (95%), cytokeratin 7 (95%), cytokeratin 20 (10%), and MUC-1 (95%), and the samples were negative for p53, carcinoembryonic antigen (CEA), and bcl-2. In contrast, ICP was positive for p63 (40%), p53 (10%), cytokeratin 7 (90%), cytokeratin 20 (20%), CEA (30%), and MUC-1 (80%), and negative for cytokeratin 5/6. However, in 84% (16) of the ISMPD samples, cytokeratin 7 was expressed only by an epithelial layer at the apical surface; this expression pattern was not found in any of the 10 ICP samples. The mean Ki67 labelling index was 1.0% in ISMPD and 18.5% in ICP. CONCLUSIONS Our study suggests that immunohistochemical staining for cytokeratin 5/6 and Ki67 constitutes the best combination for differentiating ISMPD from ICP.
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Affiliation(s)
- Kunio Mochizuki
- Department of Pathology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Yamanashi, Japan
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46
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Lotan TL, Gumuskaya B, Rahimi H, Hicks JL, Iwata T, Robinson BD, Epstein JI, De Marzo AM. Cytoplasmic PTEN protein loss distinguishes intraductal carcinoma of the prostate from high-grade prostatic intraepithelial neoplasia. Mod Pathol 2013; 26:587-603. [PMID: 23222491 PMCID: PMC3610824 DOI: 10.1038/modpathol.2012.201] [Citation(s) in RCA: 105] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Intraductal carcinoma of the prostate is a marker of aggressive disease. However, intraductal carcinoma exists on a morphologic continuum with high-grade prostatic intraepithelial neoplasia (PIN) and distinguishing intraductal carcinoma from PIN is a common diagnostic dilemma with significant clinical implications. We evaluated whether immunostains for PTEN and ERG can sensitively identify intraductal carcinoma and accurately distinguish it from high-grade PIN. A combined immunostain for PTEN, ERG, p63 and CK903 was developed and validated. Radical prostatectomy specimens with lesions meeting criteria for intraductal carcinoma (n=45), intraductal cribriform proliferations falling short of intraductal carcinoma (n=15), and PIN lesions (n=39) were retrospectively identified and assessed for PTEN and ERG. Cytoplasmic PTEN loss was identified in 84% (38/45) of the intraductal carcinoma and 100% (15/15) of intraductal cribriform proliferation cases. In contrast, cytoplasmic PTEN loss was never observed in PIN (0/39; P<0.0001). Of the 53 cases of intraductal carcinoma or intraductal cribriform proliferation with cytoplasmic PTEN loss, it was homogeneously lost in 42 cases (79%). Weak, focal nuclear positivity for PTEN was retained in 31 of these 42 cases (74%). ERG expression was identified in 58% (26/45) of intraductal carcinoma and 67% (10/15) of intraductal cribriform proliferations compared with 13% (5/39) of PIN. Concordance between the PTEN/ERG status of the intraductal carcinoma lesions and the concurrent invasive carcinoma was high (>95% and P<0.0001 for each), and substantially less for PIN and the concurrent invasive tumor (83% for PTEN and 67% for ERG; P=NS for each). Cytoplasmic PTEN loss occurs in the majority of intraductal carcinoma and intraductal cribriform proliferation cases. Cytoplasmic PTEN loss was never observed in PIN (100% specificity). Our study identifies PTEN loss as a potentially useful marker to distinguish intraductal carcinoma from PIN and provides a plausible molecular explanation for why intraductal carcinoma is associated with poor prognosis.
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Affiliation(s)
- Tamara L Lotan
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD 21205, USA.
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Weinreb I. Intraductal carcinoma of salivary gland (so-called low-grade cribriform cystadenocarcinoma) arising in an intraparotid lymph node. Head Neck Pathol 2011; 5:321-5. [PMID: 21442195 DOI: 10.1007/s12105-011-0256-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2011] [Accepted: 03/10/2011] [Indexed: 12/27/2022]
Abstract
Since the first description of an entirely intraductal epithelial proliferation of salivary gland by Chen in 1983 as an "intraductal carcinoma", there have been several dozen reported cases with the same and various additional names including "low-grade salivary duct carcinoma", "low-grade cribriform cystadenocarcinoma" and "carcinoma in situ" of salivary gland. These refer to a combination of nests and cysts of varying size formed by a cellular proliferation resembling atypical ductal hyperplasia or ductal carcinoma in situ of the breast. The lesions are generally entirely intraductal with low, intermediate or high-grade dysplasia. Occasional benign tumors of salivary gland, particularly Warthin tumor and rare salivary carcinomas may arise within an intraparotid lymph node. In addition, intraparotid lymph nodes are a routine location for metastatic disease. A case of a 59-year-old female with a parotid mass is described, which grossly had the appearance of a Warthin tumor. Microscopically, it was an entirely intranodal proliferation of cells with diffuse AE1/AE3 and S100 positivity. The nests and cysts were completely surrounded by a rim of non-neoplastic myoepithelial cells, which were positive for CK14, p63, SMA, MSA and calponin. The tumor cells were negative for these markers. The cells were only focally positive for AR and BRST-2. They showed negligible MIB-1 staining. This report describes, for the first time, an entirely intranodal location for a low-grade intraductal carcinoma (so-called low-grade cribriform cystadenocarcinoma).
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Abstract
In order to clarify the clinical significance of mutations of the p53 gene and amplification of the c-erbB-2 gene in breast carcinoma, these gene alterations were examined in 101 invasive, seven predominantly intraductal and 10 intraductal breast carcinomas by single-strand conformation polymorphism-direct sequencing or Southern blot-hybridization analysis. p53 mutations were detected in 32 (32%) of the invasive cases and two (12%) of the 17 intraductal/predominantly intraductal cases, whereas c-erbB-2 amplification was detected in 14 (14%) of the invasive and six (35%) of the intraductal/predominantly intraductal cases. Irrespective of differences in the positions and types of the mutations, cases carrying p53 mutations were almost always Grade 3 histologically and with a low hormone-receptor value. Since p53 mutations as well as c-erbB-2 amplification were detected almost selectively in Grade 3 cases but were not associated with lymph nodal status in invasive breast cancer, these two gene alterations could be indicators of prognosis of disease independent of lymph nodal status. Even in intraductal/predominantly intraductal carcinoma, these gene alterations were almost always detected in tumors of higher histologic grade. Thus, it is suggested that these gene alterations occur in breast cancers showing a high proliferation rate irrespective of the presence of invasion, and that other molecular alterations are involved in the process of breast cancer invasion.
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Affiliation(s)
- H Tsuda
- Pathology Division, National Cancer Center Research Institute and Hospital, Tokyo
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