文章：

前列腺导管内癌：分级与否的考量

Intraductal Carcinoma of the Prostate: To Grade or Not to Grade

原文发布日期：7 November 2023

DOI: 10.3390/cancers15225319

类型: Article

开放获取: 是

英文摘要：

Intraductal carcinoma of the prostate (IDC-P) is a distinct tumor type characterized by an expansile growth of atypical glandular epithelial cells within pre-existing prostate glands and ducts and has significant implications on clinical outcomes and patient management. There is an agreement that isolated IDC-P should not be graded, and IDC-P should be reported with a comment on its clinical significance. However, whether IDC-P should be factored into Grade Group (GG) in the presence of concurrent prostate cancer (PCa) has been debated vigorously. The contradicting opinions were promulgated when the Genitourinary Pathology Society (GUPS) and the International Society of Urological Pathologists (ISUP) published their recommendations for this issue. When IDC-P is present with PCa, the ISUP recommends incorporating it in the GG for the entire case, whereas the GUPS recommends excluding it from the final GG. Consequently, pathologists and clinicians are faced with the conundrum of conflicting recommendations. In this review article, the authors evaluate the magnitude of discrepant GG between the two grading methods, explore the rationales behind the differing views of the two urological societies, present the current reporting practices for IDC-P, and propose a provisional and pragmatic guide to alleviate the dilemma of which recommendation to follow.

摘要翻译： 

前列腺导管内癌（IDC-P）是一种独特的肿瘤类型，其特征为不典型腺上皮细胞在原有前列腺腺体和导管内呈膨胀性生长，对临床预后及患者管理具有重要影响。学界普遍认为，孤立性IDC-P不应进行分级，且病理报告中需对其临床意义加以注释。然而，当IDC-P与前列腺癌（PCa）共存时，是否应将其纳入分级组（GG）仍存在激烈争议。泌尿生殖病理学会（GUPS）和国际泌尿病理学会（ISUP）就该问题发布推荐意见后，相互矛盾的观点进一步凸显：ISUP建议将IDC-P纳入整体病例的GG评估，而GUPS则主张将其排除在最终GG之外。这导致病理学家和临床医生面临推荐意见冲突的困境。本文通过评估两种分级方法导致的GG差异程度，剖析两个泌尿学会观点分歧的内在逻辑，梳理当前IDC-P的病理报告实践现状，并提出一项临时性实用指南，以缓解临床选择遵循何种推荐的难题。

原文链接：

Intraductal Carcinoma of the Prostate: To Grade or Not to Grade