The 2019 Genitourinary Pathology Society (GUPS) White Paper on Contemporary Grading of Prostate Cancer
Por:
Epstein, JI, Amin, MB, Fine, SW, Algaba, F, Aron, M, Baydar, DE, Beltran, AL, Brimo, F, Cheville, JC, Colecchia, M, Comperat, E, da Cunha, IW, Delprado, W, DeMarzo, AM, Giannico, GA, Gordetsky, JB, Guo, CC, Hansel, DE, Hirsch, MS, Huang, JT, Humphrey, PA, Jimenez, RE, Khani, F, Kong, QN, Kryvenko, ON, Kunju, LP, Lal, P, Latour, M, Lotan, T, Maclean, F, Magi-Galluzzi, C, Mehra, R, Menon, S, Miyamoto, H, Montironi, R, Netto, GJ, Nguyen, JK, Osunkoya, AO, Parwani, A, Robinson, BD, Rubin, MA, Shah, RB, So, JS, Takahashi, H, Tavora, F, Tretiakova, MS, True, L, Wobker, SE, Yang, XMJ, Zhou, M, Zynger, DL, Trpkov, K
Publicada:
1 abr 2021
Resumen:
Context.-Controversies and uncertainty persist in prostate cancer grading. prostate cancer grading.
Objective.-To update grading recommendations
Data Sources.-Critical review of the literature along with pathology and clinician surveys.
Conclusions.-Percent Gleason pattern 4 (%GP4) is as follows: (1) report %GP4 in needle biopsy with Grade Groups (GrGp) 2 and 3, and in needle biopsy on other parts (jars) of lower grade in cases with at least 1 part showing Gleason score (GS) 4 + 4 = 8; and (2) report %GP4: less than 5% or less than 10% and 10% increments thereafter. Tertiary grade patterns are as follows: (1) replace "tertiary grade pattern'' in radical prostatectomy (RP) with "minor tertiary pattern 5 (TP5),'' and only use in RP with GrGp 2 or 3 with less than 5% Gleason pattern 5; and (2) minor TP5 is noted along with the GS, with the GrGp based on the GS. Global score and magnetic resonance imaging (MRI)targeted biopsies are as follows: (1) when multiple undesignated cores are taken from a single MRI-targeted lesion, an overall grade for that lesion is given as if all the involved cores were one long core; and (2) if providing a global score, when different scores are found in the standard and the MRI-targeted biopsy, give a single global score (factoring both the systematic standard and the MRI-targeted positive cores). Grade Groups are as follows: (1) Grade Groups (GrGp) is the terminology adopted by major world organizations; and (2) retain GS 3 + 5 = 8 in GrGp 4. Cribriform carcinoma is as follows: (1) report the presence or absence of cribriform glands in biopsy and RP with Gleason pattern 4 carcinoma. Intraductal carcinoma (IDCP) is as follows: (1) report IDC-P in biopsy and RP; (2) use criteria based on dense cribriform glands (>50% of the gland is composed of epithelium relative to luminal spaces) and/or solid nests and/or marked pleomorphism/necrosis; (3) it is not necessary to perform basal cell immunostains on biopsy and RP to identify IDC-P if the results would not change the overall (highest) GS/GrGp part per case; (4) do not include IDC-P in determining the final GS/GrGp on biopsy and/or RP; and (5) "atypical intraductal proliferation (AIP)'' is preferred for an intraductal proliferation of prostatic secretory cells which shows a greater degree of architectural complexity and/or cytological atypia than typical high-grade prostatic intraepithelial neoplasia, yet falling short of the strict diagnostic threshold for IDC-P. Molecular testing is as follows: (1) Ki67 is not ready for routine clinical use; (2) additional studies of active surveillance cohorts are needed to establish the utility of PTEN in this setting; and (3) dedicated studies of RNA-based assays in active surveillance populations are needed to substantiate the utility of these expensive tests in this setting. Artificial intelligence and novel grading schema are as follows: (1) incorporating reactive stromal grade, percent GP4, minor tertiary GP5, and cribriform/intraductal carcinoma are not ready for adoption in current practice.
Filiaciones:
Epstein, JI:
Johns Hopkins Med Inst, Dept Pathol, Baltimore, MD 21205 USA
Johns Hopkins Med Inst, Dept Urol, Baltimore, MD USA
Johns Hopkins Med Inst, Dept Oncol, Baltimore, MD 21205 USA
Amin, MB:
Univ Tennessee Hlth Sci, Dept Pathol & Lab Med & Urol, Memphis, TN USA
Fine, SW:
Mem Sloan Kettering Canc Ctr, Dept Pathol, 1275 York Ave, New York, NY 10021 USA
Algaba, F:
Fundacio Puigvert, Dept Pathol, Barcelona, Spain
Aron, M:
Univ Southern Calif, Dept Pathol, Los Angeles, CA USA
Baydar, DE:
Koc Univ, Fac Med, Dept Pathol, Istanbul, Turkey
Beltran, AL:
Champalimaud Ctr Unknown, Dept Pathol, Lisbon, Portugal
Brimo, F:
McGill Univ Hlth Ctr, Dept Pathol, Montreal, PQ, Canada
Cheville, JC:
Mayo Clin, Dept Pathol, Rochester, MN USA
Colecchia, M:
Fdn IRCCS Ist Nazl Tumori, Dept Pathol & Lab Med, Milan, Italy
Comperat, E:
Sorbonne Univ, Dept Pathol, Hop Tenon, Paris, France
da Cunha, IW:
Rede DOR Sao Luiz, Pathol Dept, Sao Paulo, SP, Brazil
Delprado, W:
Douglass Hanly Moir Pathol, Sydney, NSW, Australia
DeMarzo, AM:
Johns Hopkins Med Inst, Dept Pathol, Baltimore, MD 21205 USA
Giannico, GA:
Vanderbilt Univ Sch Med, Dept Pathol Microbiol & Immunol, Nashville, TN USA
Gordetsky, JB:
Vanderbilt Univ Sch Med, Dept Pathol Microbiol & Immunol, Nashville, TN USA
Guo, CC:
Univ Texas MD Anderson Canc Ctr, Dept Pathol, Houston, TX USA
Hansel, DE:
Oregon Hlth & Sci Univ, Dept Pathol, Portland, OR 97201 USA
Hirsch, MS:
Harvard Med Sch, Brigham & Womens Hosp, Dept Pathol, Boston, MA USA
Huang, JT:
UCLA, Dept Pathol & Lab Med, David Geffen Sch Med, Los Angeles, CA USA
Humphrey, PA:
Yale Sch Med, Dept Pathol, New Haven, CT USA
Jimenez, RE:
Mayo Clin, Dept Pathol, Rochester, MN USA
Khani, F:
Weill Cornell Med, Dept Pathol & Lab Med & Urol, New York, NY USA
Kong, QN:
Qingdao Municipal Hosp, Dept Pathol, Qingdao, Shandong, Peoples R China
Kaiser Permanente Sacramento Med Ctr, Sacramento, CA USA
Kryvenko, ON:
Univ Miami, Dept Pathol & Lab Med, Miller Sch Med, Miami, FL USA
Univ Miami, Sylvester Comprehens Canc Ctr, Miller Sch Med, Miami, FL USA
Kunju, LP:
Univ Michigan, Sch Med, Dept Pathol, Ann Arbor, MI USA
Lal, P:
Univ Penn, Perelman Sch Med, Philadelphia, PA USA
Latour, M:
Univ Montreal, Dept Pathol, CHUM, Montreal, PQ, Canada
Lotan, T:
Johns Hopkins Med Inst, Dept Pathol, Baltimore, MD 21205 USA
Maclean, F:
Macquarie Univ, Douglass Hanly Moir Pathol, Fac Med & Hlth Sci, N Ryde, Australia
Magi-Galluzzi, C:
Univ Alabama Birmingham, Dept Pathol, Birmingham, AL USA
Mehra, R:
Univ Michigan, Sch Med, Dept Pathol, Ann Arbor, MI USA
Menon, S:
Tata Mem Hosp, Dept Surg Pathol, Mumbai, Maharashtra, India
Miyamoto, H:
Univ Rochester, Med Ctr, Dept Pathol & Lab Med, Rochester, NY 14642 USA
Univ Rochester, Med Ctr, Dept Urol, Rochester, NY 14642 USA
Montironi, R:
Polytech Univ Marche Reg, United Hosp, Sch Med, Sect Pathol Anat, Ancona, Italy
Netto, GJ:
Univ Alabama Birmingham, Dept Pathol, Birmingham, AL USA
Nguyen, JK:
Cleveland Clin, Robert J Tomsich Pathol & Lab Med Inst, Cleveland, OH USA
Osunkoya, AO:
Emory Univ, Sch Med, Dept Pathol, Atlanta, GA 30322 USA
Parwani, A:
Ohio State Univ, Dept Pathol, Columbus, OH 43210 USA
Robinson, BD:
Weill Cornell Med, Dept Pathol & Lab Med & Urol, New York, NY USA
Rubin, MA:
Univ Bern, Dept BioMed Res, Bern, Switzerland
Shah, RB:
Univ Texas Southwestern Med Ctr, Dept Pathol, Dallas, TX USA
So, JS:
St Lukes Med Ctr, Inst Pathol, Quezon City, Philippines
St Lukes Med Ctr, Inst Pathol, Global City, Philippines
Takahashi, H:
Jikei Univ, Dept Pathol, Sch Med, Tokyo, Japan
Tavora, F:
Univ Fed Ceara, Argos Lab, Fortaleza, Ceara, Brazil
Tretiakova, MS:
Univ Washington, Sch Med, Dept Pathol, Seattle, WA 98195 USA
True, L:
Univ Washington, Sch Med, Dept Pathol, Seattle, WA 98195 USA
Wobker, SE:
Univ N Carolina, Dept Pathol & Lab Med, Chapel Hill, NC USA
Univ N Carolina, Dept Urol, Chapel Hill, NC USA
Yang, XMJ:
Northwestern Univ, Dept Pathol, Chicago, IL 60611 USA
Zhou, M:
Tufts Med Ctr, Dept Pathol, Boston, MA USA
Zynger, DL:
Ohio State Univ, Dept Pathol, Columbus, OH 43210 USA
Trpkov, K:
Univ Calgary, Dept Pathol & Lab Med, Calgary, AB, Canada
Green Submitted, gold
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