前列腺腺泡腺癌约占前列腺癌(CaP)病例的95%。已知其余5%的CaP组织学亚型更具侵略性,最近引起了广泛关注。这些组织学亚型-即,前列腺导管腺癌(PDA),前列腺导管内癌(IDC-P),和前列腺的筛状癌(CC-P)-通常表现出不同的生长特征,基因组特征,和独特的肿瘤学结果。例如,PTEN突变,导致不受控制的细胞生长,经常出现在IDC-P和CC-P中。同源DNA重组修复(HRR)基因中的种系突变(例如,BRCA1,BRCA2,ATM,PALB2和CHEK2)在40%的IDC-P患者中发现,而无导管受累的患者中只有9%有种系突变。CC-P与常见抑癌基因的缺失有关,包括PTEN,TP53、NKX3-1、MAP3K7、RB1和CHD1。有证据表明,阿比特龙作为IDC-P患者的一线治疗方法可能优于多西他赛。为了解决这些和其他关键的病理属性,这篇综述探讨了分子病理学,遗传学,治疗,和与CC-P相关的肿瘤学结果,PDA,和IDC-P,目的是在PDA上创建具有集中式信息库的综合资源,IDC-P,和CC-P
Prostatic acinar adenocarcinoma accounts for approximately 95% of prostate cancer (CaP) cases. The remaining 5% of histologic subtypes of CaP are known to be more aggressive and have recently garnered substantial attention. These histologic subtypes - namely, prostatic ductal adenocarcinoma (PDA), intraductal carcinoma of the prostate (IDC-P), and cribriform carcinoma of the prostate (CC-P) - typically exhibit distinct growth characteristics, genomic features, and unique oncologic outcomes. For example, PTEN mutations, which cause uncontrolled cell growth, are frequently present in IDC-P and CC-P. Germline mutations in homologous DNA recombination repair (HRR) genes (e.g., BRCA1, BRCA2, ATM, PALB2, and CHEK2) are discovered in 40% of patients with IDC-P, while only 9% of patients without ductal involvement had a germline mutation. CC-P is associated with deletions in common tumor suppressor genes, including PTEN, TP53, NKX3-1, MAP3K7, RB1, and CHD1. Evidence suggests abiraterone may be superior to docetaxel as a first-line treatment for patients with IDC-P. To address these and other critical pathological attributes, this review examines the molecular pathology, genetics, treatments, and oncologic outcomes associated with CC-P, PDA, and IDC-P with the objective of creating a comprehensive resource with a centralized repository of information on PDA, IDC-P, and CC-P.