Patterns of differentiation and proliferation in intraductal carcinoma of the prostate: significance for cancer progression

Prostate. 2000 Apr 1;43(1):11-9. doi: 10.1002/(sici)1097-0045(20000401)43:1<11::aid-pros3>;2-b.


Background: Cribriform prostatic intraepithelial neoplasia (C-PIN) identifies a unique histological pattern: dysplastic cells line ductal/acinar walls but also span across gland lumens. C-PIN is distinct from other forms of dysplasia; it is seldom seen except within invasive cancer, it is more frequent in larger/higher-grade cancers; and it appears to contribute independently to aggressive behavior. Hence, C-PIN may represent a separate, more aggressive entity: intraductal carcinoma of the prostate (IDC-P). Here, support for that distinction stems from a histologic/biologic subclassification of IDC-P, whose elements are linked to features of invasive cancer.

Methods: Histologic criteria were tested against 26 radical prostatectomies, using immunostains for prostate-specific antigen, MUC-2, androgen receptor (differentiation), and Ki-67 (proliferation). Invasive cancer grade, stage, and follow-up were compared.

Results: Architecture of the central (luminal) cell compartment defined three subclasses of IDC-P: A (trabecular), B (cribriform), and C (solid/comedo), which represented progressive dedifferentiation with a reciprocal increase in proliferation. The IDC-P subpattern correlated with cancer stage, grade, and clinical course.

Conclusions: IDC-P is a separate entity, distinct from PIN; cancers associated with IDC-P are more aggressive than those associated with only PIN. It comprises a spectrum of histological patterns which appear to be determined in concert with invasive cancer, whose prognosis it worsens.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Carcinoma / pathology*
  • Cell Differentiation
  • Cell Division
  • Cytoplasm / pathology
  • Disease Progression
  • Humans
  • Immunologic Techniques
  • Male
  • Prostatic Neoplasms / pathology*
  • Staining and Labeling