侵袭性筛孔腺体大小及比例在格里森评分7前列腺腺癌中的预后意义
Prognostic significance of invasive cribriform gland size and percentage in Gleason score 7 prostate adenocarcinoma
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影响因子:1.9
分区:医学4区 / 病理学3区
发表日期:2024 Aug 09
作者:
Emel Tekin, Nazlı Sena Şeker, Ata Özen, Mustafa Fuat Açıkalın, Cavit Can, Ertuğrul Çolak
DOI:
10.1093/ajcp/aqae082
摘要
筛孔腺体与前列腺腺癌预后较差相关。我们旨在评估格里森评分7前列腺腺癌中筛孔腺体比例及最大侵袭性筛孔腺体大小的预后作用。研究了177例2-3级别前列腺腺癌中侵袭性筛孔腺体的存在、比例及大小，并评估其与预后因素的相关性。生化复发无病生存期在筛孔腺体比例超过10%（P<.001）及最大侵袭性筛孔腺体大小超过0.5 mm（P<.001）的病例中显著较短。平均最大筛孔腺体大小和比例与更高级别的pT期、淋巴结转移、生化复发及术前前列腺特异性抗原（PSA）水平升高均具有统计学显著相关性。我们的研究结果表明，筛孔型模式的存在、该模式比例的增加以及肿瘤内最大筛孔腺体大小的增加均与预后不良相关。我们建议，对于筛孔腺体侵袭大于0.5 mm且筛孔腺体比例大于10%的2-3级别患者，尤其是前列腺针穿刺活检标本，可能需要采取更积极的临床治疗策略。© 作者版权所有，2024年牛津大学出版社代表美国临床病理学会出版。商业再使用请联系reprints@oup.com获取再版和翻译权，其他权限请通过我们网站文章页面的Permissions链接通过RightsLink服务获得——详细信息请联系journals.permissions@oup.com。
Abstract
Cribriform glands are linked to poorer outcomes in prostate adenocarcinoma. We aimed to assess the prognostic role of the percentage of cribriform glands and the size of the largest invasive cribriform gland in Gleason score 7 prostate adenocarcinomas.The presence, percentage, and size of the invasive cribriform glands were investigated and their association with prognostic factors were assessed in 177 Grade Groups 2 and 3 prostate adenocarcinomas.Biochemical recurrence-free survival was statistically significantly lower in cases with a cribriform gland percentage greater than 10% (P < .001) and in cases where the largest invasive cribriform gland size was greater than 0.5 mm (P < .001). Mean largest cribriform gland size and percentage were statistically significant associated with more advanced pT status, lymph node metastasis, biochemical recurrence, and higher preoperative prostate-specific antigen values.Our findings suggest that the presence of a cribriform pattern, increases in the percentage of such patterns, and increases in the size of the largest cribriform gland within a given tumor are associated with poor prognosis. We suggest that a more aggressive clinical approach may be needed in Grade Group 2 and 3 cases with invasive cribriform glands larger than 0.5 mm and a cribriform gland percentage greater than 10%, especially in prostate needle biopsy specimens.© The Author(s) 2024. Published by Oxford University Press on behalf of American Society for Clinical Pathology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.