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Digital Quantification of Five High-Grade Prostate Cancer Patterns, Including the Cribriform Pattern, and Their Association With Adverse Outcome
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Digital Quantification of Five High-Grade Prostate Cancer Patterns, Including the Cribriform Pattern, and Their Association With Adverse Outcome
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Digital Quantification of Five High-Grade Prostate Cancer Patterns, Including the Cribriform Pattern, and Their Association With Adverse Outcome
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Journal Article
Digital Quantification of Five High-Grade Prostate Cancer Patterns, Including the Cribriform Pattern, and Their Association With Adverse Outcome
2011
Overview
Proper grading of the cribriform prostate cancer pattern has not previously been supported by outcome-based evidence. Among 153 men who underwent radical prostatectomy, 76 with prostate-specific antigen (PSA) failure (≥0.2 ng/mL [0.2 μg/L]) were matched to 77 without failure. Frequencies of high-grade patterns included fused small acini, 83.7%; papillary, 52.3%; large cribriform, 37.9%; small (≤12 lumens) cribriform, 17.0%; and individual cells, 22.9%. A cribriform pattern was present in 61% (46/76) of failures but 16% (12/77) of nonfailures (P < .0001). Multivariate analysis showed the cribriform pattern had the highest odds ratio for PSA failure, 5.89 (95% confidence interval, 2.53-13.70; P < .0001). The presence of both large and small cribriform patterns was significantly linked to failure. The cumulative odds ratio of failure per added square millimeter of cribriform pattern was 1.173 (P = .008), higher than for any other pattern. All 8 men with a cribriform area sum of 25 mm(2) or more had failure (range, 33-930). Regrading cribriform cancer as Gleason 5 improved the grade association with failure, although half of all cases with individual cells also had a cribriform pattern, precluding a precise determination of the independent importance of the latter. The cribriform pattern has particularly adverse implications for outcome.
Publisher
American Society of Clinical Pathologists,Oxford University Press
Subject
/ Biological and medical sciences
/ Gynecology. Andrology. Obstetrics
/ Humans
/ Investigative techniques, diagnostic techniques (general aspects)
/ Male
/ Nephrology. Urinary tract diseases
/ Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques
/ Prostatic Neoplasms - pathology
/ Prostatic Neoplasms - surgery
/ Tumors
