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Concordance of cribriform architecture in matched prostate cancer biopsy and radical prostatectomy specimens
Author(s) -
Hollemans Eva,
Verhoef Esther I,
Bangma Chris H,
Schoots Ivo,
Rietbergen John,
Helleman Jozien,
Roobol Monique J,
Leenders Geert J L H
Publication year - 2019
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/his.13893
Subject(s) - prostatectomy , cribriform , medicine , biopsy , prostate cancer , urology , odds ratio , cancer , pathology , carcinoma
Aims Invasive cribriform and/or intraductal carcinoma have been identified as independent adverse parameters for prostate cancer outcome. Little is known on biopsy undersampling of cribriform architecture. Our aim was to determine the extent of cribriform architecture undersampling and to find predictive factors for identifying false cribriform‐negative cases. Methods and results We reviewed 186 matched prostate biopsies and radical prostatectomy specimens. Of 97 biopsy grade group 2 (Gleason score 3 + 4 = 7) patients, 22 (23%) had true cribriform‐negative (TN), 39 (40%) false‐negative (FN) and 36 (37%) true‐positive (TP) biopsies. Patients with FN biopsies had higher, although not statistically significant ( P = 0.06), median PSA levels than patients with TP biopsies (12 versus 8 ng/ml). A PI‐RADS 5 lesion was present in nine of 16 (54%) FN and three of 11 (27%) TN biopsies ( P = 0.05). Positive biopsy rate ( P = 0.47), percentage Gleason pattern 4 ( P = 0.55) and glomeruloid architecture ( P = 1.0) were not different. Logistic regression identified PSA as an independent predictor (odds ratio = 3.5; 95% confidence interval = 1.2–9.4, P = 0.02) for cribriform architecture on radical prostatectomy, but not PI‐RADS score. The FN rate for large cribriform architecture at radical prostatectomy was 27%, which was lower than for any cribriform architecture ( P = 0.01). During follow‐up (median 27 months), biochemical recurrence‐free survival of patients with TP biopsies was significantly shorter than that of those with FN biopsies ( P = 0.03). Conclusion In conclusion, 40% of grade group 2 prostate cancer biopsies were FN for cribriform architecture. These patients had higher PSA levels and more frequent PI‐RADS score 5 lesions than men with TN biopsies.