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Abstract：
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：
前列腺导管内癌（IDC-P）是一种独特的肿瘤类型，其特征是预先存在的前列腺和导管内非典型腺上皮细胞的扩张性生长，对临床结果和患者管理具有重要意义。有一个协议，孤立的IDC-P不应该被分级，和IDC-P应报告其临床意义。然而,在并发前列腺癌(PCa)的情况下,IDC-P是否应被纳入GradeGroup(GG)的因素一直存在激烈争论.当泌尿生殖道病理学学会（GUPS）和国际泌尿病理学家学会（ISUP）发表有关此问题的建议时，发表了矛盾的观点。当IDC-P与PCa一起出现时，ISUP建议将其纳入整个案件的GG，而GUPS建议将其从最终GG中排除。因此,病理学家和临床医生面临着相互矛盾的建议的难题.在这篇评论文章中，作者评估了两种分级方法之间GG差异的大小，探索两个泌尿外科社会不同观点背后的理由，介绍IDC-P的当前报告实践，并提出一个临时和务实的指南，以缓解应遵循的建议的困境。
