Interobserver reproducibility of cribriform cancer in prostate needle biopsies and validation of International Society of Urological Pathology criteria

Lars Egevad*, Brett Delahunt, Kenneth A. Iczkowski, Theo van der Kwast, Geert J.L.H. van Leenders, Katia R.M. Leite, Chin Chen Pan, Hemamali Samaratunga, Toyonori Tsuzuki, Nita Mulliqi, Xiaoyi Ji, Henrik Olsson, Masi Valkonen, Pekka Ruusuvuori, Martin Eklund, Kimmo Kartasalo

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Aims: There is strong evidence that cribriform morphology indicates a worse prognosis of prostatic adenocarcinoma. Our aim was to investigate its interobserver reproducibility in prostate needle biopsies. Methods and results: A panel of nine prostate pathology experts from five continents independently reviewed 304 digitised biopsies for cribriform cancer according to recent International Society of Urological Pathology criteria. The biopsies were collected from a series of 702 biopsies that were reviewed by one of the panellists for enrichment of high-grade cancer and potentially cribriform structures. A 2/3 consensus diagnosis of cribriform and noncribriform cancer was reached in 90% (272/304) of the biopsies with a mean kappa value of 0.56 (95% confidence interval 0.52–0.61). The prevalence of consensus cribriform cancers was estimated to 4%, 12%, 21%, and 20% of Gleason scores 7 (3 + 4), 7 (4 + 3), 8, and 9–10, respectively. More than two cribriform structures per level or a largest cribriform mass with ≥9 lumina or a diameter of ≥0.5 mm predicted a consensus diagnosis of cribriform cancer in 88% (70/80), 84% (87/103), and 90% (56/62), respectively, and noncribriform cancer in 3% (2/80), 5% (5/103), and 2% (1/62), respectively (all P < 0.01). Conclusion: Cribriform prostate cancer was seen in a minority of needle biopsies with high-grade cancer. Stringent diagnostic criteria enabled the identification of cribriform patterns and the generation of a large set of consensus cases for standardisation.

Original languageEnglish
Pages (from-to)837-845
Number of pages9
Issue number6
Publication statusPublished - May 2023

Bibliographical note

Funding Information:
The study received funding from the Swedish Cancer Foundation (20 1358), the Stockholm Cancer Society (204043), David and Astrid Hägelén Foundation, Orion Research Foundation, and Oskar Huttunen Foundation.

Publisher Copyright:
© 2023 The Authors. Histopathology published by John Wiley & Sons Ltd.


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