Proliferation index of different Gleason pattern 4 histomorphologies and associated pattern 3 adenocarcinoma of the prostate

Publication date: Available online 27 June 2017
Source:Human Pathology
Author(s): Liying Fu, Michael Hwang, Adebowale J. Adeniran, Peter A. Humphrey
Gleason grade is one of the most powerful prognostic indicators for adenocarcinoma of the prostate. A higher proliferation index of prostatic adenocarcinoma has been demonstrated in numerous studies to be significantly associated with more aggressive behavior. To date, the proliferation index of the different Gleason pattern 4 histomorphologies, including cribriform, fused glands, and poorly-formed glands, has not been determined. The aim of this investigation was to quantitate and compare the proliferation index, as assessed by Ki67 labeling index, of different Gleason pattern 4 histomorphologies. We also analyzed the Ki67 labeling index of Gleason pattern 3 adenocarcinoma associated with and without cribriform adenocarcinoma. Amongst Gleason pattern 4 morphologies, cribriform adenocarcinoma exhibited a higher mean proliferation index at 5.3% compared to fused gland adenocarcinoma at 3.9% (P = .03) and poorly-formed glands at 3.6% (P < .01). The mean Ki67 labeling index for Gleason pattern 3 associated with cribriform adenocarcinoma was higher at 4.1% compared to pure Gleason pattern 3 at 2.2% (P < .01) and Gleason pattern 3 associated with non-cribriform pattern 4 adenocarcinoma at 2.9% (P = .02). This higher proliferation index of Gleason pattern 3 adenocarcinoma associated with cribriform pattern 4 adenocarcinoma indicates that not all Gleason pattern 3 cells are identical and that cribriform adenocarcinoma may influence or be related to associated Gleason pattern 3. Gleason pattern 4 adenocarcinoma of the prostate with cribriform growth has a higher proliferation index than other grade 4 histomorphologies, consistent with the more clinically aggressive nature of cribriform adenocarcinoma of the prostate.



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