Faculty Collaboration Database

Cribriform prostate cancer: Morphologic criteria enabling a diagnosis, based on survey of experts. Ann Diagn Pathol 2021 Jun;52:151733

Date

03/30/2021

Pubmed ID

33780691

DOI

10.1016/j.anndiagpath.2021.151733

Scopus ID

2-s2.0-85103255761 (requires institutional sign-in at Scopus site)   8 Citations

Abstract

Among four sub-patterns of Gleason grade 4 prostate cancer, voluminous evidence supports that the cribriform pattern holds an unfavorable prognostic impact, as compared with poorly-formed, fused, or glomeruloid. The International Society of Urological Pathology (ISUP) recommends specifying whether invasive grade 4 cancer is cribriform. Recently, ISUP experts published a consensus definition of cribriform pattern highlighting criteria that distinguish it from mimickers. The current study aimed to analyze morphologic features separately to identify those that define the essence of the cribriform pattern. Thirty-two selected photomicrographs were classified by 12 urologic pathologists as: definitely cribriform cancer, probably cribriform, unsure, probably not cribriform, or definitely not cribriform. Consensus was defined as 9/12 agree or disagree, with ≤1 strongly supporting the opposite choice. Final consensus was achieved in 21 of 32 cases. Generalized estimating equation (GEE) model with logit link was fitted to estimate effect of multiple morphologic predictors. Fisher exact test was used for categorical findings. Presence of intervening stroma precluded calling cribriform cancer (p = 0.006). Mucin presence detracted (p = 0.003) from willingness to call cribriform cancer (only 3 cases had mucin). Lumen number was associated with cribriform consensus (p = 0.0006), and all consensus cases had ≥9 lumens. Predominant papillary pattern or an irregular outer boundary detracted (p = NS). Invasive cribriform carcinoma should have absence of intervening stroma, and usually neither papillary pattern, irregular outer boundary, nor very few lumens. Setting the criteria for cribriform will help prevent over- or undercalling this important finding.

Author List

Iczkowski KA, van Leenders GJLH, Tarima S, Wu R, Van der Kwast T, Berney DM, Evans AJ, Wheeler TM, Ro JY, Samaratunga H, Delahunt B, Srigley J, Varma M, Tsuzuki T, Egevad L

Author

Sergey S. Tarima PhD Associate Professor in the Institute for Health and Equity department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adenocarcinoma
Consensus
Humans
Male
Mucins
Neoplasm Grading
Neoplasm Invasiveness
Pathologists
Photomicrography
Prognosis
Prostatic Neoplasms
Societies, Medical
Surveys and Questionnaires
Urologists