Digital quantification of five high-grade prostate cancer patterns, including the cribriform pattern, and their association with adverse outcome - Abstract

Pathology, RC-1 North, 12800 E 19th Ave, Campus Mail Stop 8104, Aurora, CO 80045.


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.

Written by:
Iczkowski KA, Torkko KC, Kotnis GR, Storey Wilson R, Huang W, Wheeler TM, Abeyta AM, La Rosa FG, Cook S, Werahera PN, Scott Lucia M.   Are you the author?

Reference: Am J Clin Pathol. 2011 Jul;136(1):98-107.
doi: 10.1309/AJCPZ7WBU9YXSJPE

PubMed Abstract
PMID: 21685037 Prostate Cancer Section