Diagnosis of "poorly formed glands" Gleason pattern 4 prostatic adenocarcinoma on needle biopsy: An interobserver reproducibility study among urologic pathologists with recommendations

Ming Zhou, Jianbo Li, Liang Cheng, Lars Egevad, Fang Ming Deng, Lakshmi Priya Kunju, Cristina Magi-Galluzzi, Jonathan Melamed, Rohit Mehra, Savvas Mendrinos, Adeboye O. Osunkoya, Gladell Paner, Steve S. Shen, Toyonori Tsuzuki, Kiril Trpkov, Wei Tian, Ximing Yang, Rajal B. Shah

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Accurate recognition of Gleason pattern (GP) 4 prostate carcinoma (PCa) on needle biopsy is critical for patient management and prognostication. "Poorly formed glands" are the most common GP4 subpattern. We studied the diagnostic reproducibility and the quantitative threshold of grading GP4 "poorly formed glands" and the criteria to distinguish them from tangentially sectioned GP3 glands. Seventeen urologic pathologists were first queried for the definition of "poorly formed glands" using cases representing a spectrum of PCa glandular differentiation. Cancer glands with no or rare lumens, elongated compressed glands, and elongated nests were considered "poorly formed glands" by consensus. Participants then graded a second set of 23 PCa cases that potentially contained "poorly formed glands" with a fair interobserver agreement (k=0.34). The consensus diagnoses, defined as agreement by >70% participants, were then correlated with the quantitative (≤5, 6 to 10, >10) and topographic features of poorly formed glands (clustered, immediately adjacent to, and intermixed with other well-formed PCa glands) in each case. Poorly formed glands immediately adjacent to other well-formed glands regardless of their number and small foci of ≤5 poorly formed glands regardless of their location were not graded as GP4. In contrast, large foci of >10 poorly formed glands that were not immediately adjacent to well-formed glands were graded as GP4. Grading "poorly formed glands" is challenging. Some morphologic features are, however, reproducible for and against a GP4 diagnosis. This study represents an important step in standardization of grading of "poorly formed glands" based on quantitative and topographic morphologic features.

Original languageEnglish (US)
Pages (from-to)1331-1339
Number of pages9
JournalAmerican Journal of Surgical Pathology
Volume39
Issue number10
StatePublished - Oct 1 2015

Fingerprint

Needle Biopsy
Adenocarcinoma
Prostate
Carcinoma
GP 4
Pathologists
Neoplasms

Keywords

  • Gleason grade
  • Gleason pattern 4
  • Interobserver reproducibility
  • Poorly formed glands
  • Prostate cancer
  • Prostate needle biopsy

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine
  • Surgery

Cite this

Diagnosis of "poorly formed glands" Gleason pattern 4 prostatic adenocarcinoma on needle biopsy : An interobserver reproducibility study among urologic pathologists with recommendations. / Zhou, Ming; Li, Jianbo; Cheng, Liang; Egevad, Lars; Deng, Fang Ming; Kunju, Lakshmi Priya; Magi-Galluzzi, Cristina; Melamed, Jonathan; Mehra, Rohit; Mendrinos, Savvas; Osunkoya, Adeboye O.; Paner, Gladell; Shen, Steve S.; Tsuzuki, Toyonori; Trpkov, Kiril; Tian, Wei; Yang, Ximing; Shah, Rajal B.

In: American Journal of Surgical Pathology, Vol. 39, No. 10, 01.10.2015, p. 1331-1339.

Research output: Contribution to journalArticle

Zhou, M, Li, J, Cheng, L, Egevad, L, Deng, FM, Kunju, LP, Magi-Galluzzi, C, Melamed, J, Mehra, R, Mendrinos, S, Osunkoya, AO, Paner, G, Shen, SS, Tsuzuki, T, Trpkov, K, Tian, W, Yang, X & Shah, RB 2015, 'Diagnosis of "poorly formed glands" Gleason pattern 4 prostatic adenocarcinoma on needle biopsy: An interobserver reproducibility study among urologic pathologists with recommendations', American Journal of Surgical Pathology, vol. 39, no. 10, pp. 1331-1339.
Zhou, Ming ; Li, Jianbo ; Cheng, Liang ; Egevad, Lars ; Deng, Fang Ming ; Kunju, Lakshmi Priya ; Magi-Galluzzi, Cristina ; Melamed, Jonathan ; Mehra, Rohit ; Mendrinos, Savvas ; Osunkoya, Adeboye O. ; Paner, Gladell ; Shen, Steve S. ; Tsuzuki, Toyonori ; Trpkov, Kiril ; Tian, Wei ; Yang, Ximing ; Shah, Rajal B. / Diagnosis of "poorly formed glands" Gleason pattern 4 prostatic adenocarcinoma on needle biopsy : An interobserver reproducibility study among urologic pathologists with recommendations. In: American Journal of Surgical Pathology. 2015 ; Vol. 39, No. 10. pp. 1331-1339.
@article{89cb99a074114f35ad62df4c816ed5e6,
title = "Diagnosis of {"}poorly formed glands{"} Gleason pattern 4 prostatic adenocarcinoma on needle biopsy: An interobserver reproducibility study among urologic pathologists with recommendations",
abstract = "Accurate recognition of Gleason pattern (GP) 4 prostate carcinoma (PCa) on needle biopsy is critical for patient management and prognostication. {"}Poorly formed glands{"} are the most common GP4 subpattern. We studied the diagnostic reproducibility and the quantitative threshold of grading GP4 {"}poorly formed glands{"} and the criteria to distinguish them from tangentially sectioned GP3 glands. Seventeen urologic pathologists were first queried for the definition of {"}poorly formed glands{"} using cases representing a spectrum of PCa glandular differentiation. Cancer glands with no or rare lumens, elongated compressed glands, and elongated nests were considered {"}poorly formed glands{"} by consensus. Participants then graded a second set of 23 PCa cases that potentially contained {"}poorly formed glands{"} with a fair interobserver agreement (k=0.34). The consensus diagnoses, defined as agreement by >70{\%} participants, were then correlated with the quantitative (≤5, 6 to 10, >10) and topographic features of poorly formed glands (clustered, immediately adjacent to, and intermixed with other well-formed PCa glands) in each case. Poorly formed glands immediately adjacent to other well-formed glands regardless of their number and small foci of ≤5 poorly formed glands regardless of their location were not graded as GP4. In contrast, large foci of >10 poorly formed glands that were not immediately adjacent to well-formed glands were graded as GP4. Grading {"}poorly formed glands{"} is challenging. Some morphologic features are, however, reproducible for and against a GP4 diagnosis. This study represents an important step in standardization of grading of {"}poorly formed glands{"} based on quantitative and topographic morphologic features.",
keywords = "Gleason grade, Gleason pattern 4, Interobserver reproducibility, Poorly formed glands, Prostate cancer, Prostate needle biopsy",
author = "Ming Zhou and Jianbo Li and Liang Cheng and Lars Egevad and Deng, {Fang Ming} and Kunju, {Lakshmi Priya} and Cristina Magi-Galluzzi and Jonathan Melamed and Rohit Mehra and Savvas Mendrinos and Osunkoya, {Adeboye O.} and Gladell Paner and Shen, {Steve S.} and Toyonori Tsuzuki and Kiril Trpkov and Wei Tian and Ximing Yang and Shah, {Rajal B.}",
year = "2015",
month = "10",
day = "1",
language = "English (US)",
volume = "39",
pages = "1331--1339",
journal = "American Journal of Surgical Pathology",
issn = "0147-5185",
publisher = "Lippincott Williams and Wilkins",
number = "10",

}

TY - JOUR

T1 - Diagnosis of "poorly formed glands" Gleason pattern 4 prostatic adenocarcinoma on needle biopsy

T2 - An interobserver reproducibility study among urologic pathologists with recommendations

AU - Zhou, Ming

AU - Li, Jianbo

AU - Cheng, Liang

AU - Egevad, Lars

AU - Deng, Fang Ming

AU - Kunju, Lakshmi Priya

AU - Magi-Galluzzi, Cristina

AU - Melamed, Jonathan

AU - Mehra, Rohit

AU - Mendrinos, Savvas

AU - Osunkoya, Adeboye O.

AU - Paner, Gladell

AU - Shen, Steve S.

AU - Tsuzuki, Toyonori

AU - Trpkov, Kiril

AU - Tian, Wei

AU - Yang, Ximing

AU - Shah, Rajal B.

PY - 2015/10/1

Y1 - 2015/10/1

N2 - Accurate recognition of Gleason pattern (GP) 4 prostate carcinoma (PCa) on needle biopsy is critical for patient management and prognostication. "Poorly formed glands" are the most common GP4 subpattern. We studied the diagnostic reproducibility and the quantitative threshold of grading GP4 "poorly formed glands" and the criteria to distinguish them from tangentially sectioned GP3 glands. Seventeen urologic pathologists were first queried for the definition of "poorly formed glands" using cases representing a spectrum of PCa glandular differentiation. Cancer glands with no or rare lumens, elongated compressed glands, and elongated nests were considered "poorly formed glands" by consensus. Participants then graded a second set of 23 PCa cases that potentially contained "poorly formed glands" with a fair interobserver agreement (k=0.34). The consensus diagnoses, defined as agreement by >70% participants, were then correlated with the quantitative (≤5, 6 to 10, >10) and topographic features of poorly formed glands (clustered, immediately adjacent to, and intermixed with other well-formed PCa glands) in each case. Poorly formed glands immediately adjacent to other well-formed glands regardless of their number and small foci of ≤5 poorly formed glands regardless of their location were not graded as GP4. In contrast, large foci of >10 poorly formed glands that were not immediately adjacent to well-formed glands were graded as GP4. Grading "poorly formed glands" is challenging. Some morphologic features are, however, reproducible for and against a GP4 diagnosis. This study represents an important step in standardization of grading of "poorly formed glands" based on quantitative and topographic morphologic features.

AB - Accurate recognition of Gleason pattern (GP) 4 prostate carcinoma (PCa) on needle biopsy is critical for patient management and prognostication. "Poorly formed glands" are the most common GP4 subpattern. We studied the diagnostic reproducibility and the quantitative threshold of grading GP4 "poorly formed glands" and the criteria to distinguish them from tangentially sectioned GP3 glands. Seventeen urologic pathologists were first queried for the definition of "poorly formed glands" using cases representing a spectrum of PCa glandular differentiation. Cancer glands with no or rare lumens, elongated compressed glands, and elongated nests were considered "poorly formed glands" by consensus. Participants then graded a second set of 23 PCa cases that potentially contained "poorly formed glands" with a fair interobserver agreement (k=0.34). The consensus diagnoses, defined as agreement by >70% participants, were then correlated with the quantitative (≤5, 6 to 10, >10) and topographic features of poorly formed glands (clustered, immediately adjacent to, and intermixed with other well-formed PCa glands) in each case. Poorly formed glands immediately adjacent to other well-formed glands regardless of their number and small foci of ≤5 poorly formed glands regardless of their location were not graded as GP4. In contrast, large foci of >10 poorly formed glands that were not immediately adjacent to well-formed glands were graded as GP4. Grading "poorly formed glands" is challenging. Some morphologic features are, however, reproducible for and against a GP4 diagnosis. This study represents an important step in standardization of grading of "poorly formed glands" based on quantitative and topographic morphologic features.

KW - Gleason grade

KW - Gleason pattern 4

KW - Interobserver reproducibility

KW - Poorly formed glands

KW - Prostate cancer

KW - Prostate needle biopsy

UR - http://www.scopus.com/inward/record.url?scp=84941797079&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84941797079&partnerID=8YFLogxK

M3 - Article

C2 - 26099009

AN - SCOPUS:84941797079

VL - 39

SP - 1331

EP - 1339

JO - American Journal of Surgical Pathology

JF - American Journal of Surgical Pathology

SN - 0147-5185

IS - 10

ER -