Introduction: Intraductal carcinoma is often associated with high-grade, high-stage adenocarcinoma. Its frequency is variable and it is considered a poor prognostic factor. In our context, when prostatic carcinoma is diagnosed, pathologists do not always report the presence of this anatomopathological entity. We therefore conducted a study to determine the epidemiological and anatomopathological profile of patients with this lesion in Dakar. Materials and Methods: This is a retrospective descriptive study covering a 1-year period from January to December 2022. It focused on cases of intraductal carcinoma diagnosed among prostatic carcinomas collected in the anatomopathology laboratories of Hôpital Général Idrissa Pouye (HOGIP) and Hôpital Militaire de Ouakam (HMO). It was based on archives of anatomopathological reports, blocks and slides. A total of 200 cases of prostatic carcinoma were collated and reviewed to identify those presenting with intraductal carcinoma according to the diagnostic criteria of Guo and Epstein. Results: 87 cases of intraductal carcinoma were found, representing 43.5% of prostatic carcinomas. The mean age was 71 years. Patients in their seventh decade were the most represented, i.e. 42.5%. The majority of samples examined were biopsies (72.4%). The mean PSA level was 965.91 ng/ml, with extremes ranging from 0.03 to 10,000 ng/ml. Histologically, 96.5% of cases (N = 84) were invasive prostatic carcinoma. Gleason score 8 (4 + 4) was the most common, accounting for 42.53% (N = 37). On average, the study found four (04) foci of intraductal carcinoma per specimen, with extremes ranging from 1 to 30. Dense cribriform architecture accounted for 78.16%, loose cribriform for 11.5%, solid for 8.04% and micropapillary for 2.3%. Six cases (6.9%) showed foci of comedonecrosis. The vast majority of radical prostatectomies (87.5%) were classified as pT3. Node invasion and perineural sheathing were observed in 12.5% and 52.32% of cases respectively. Conclusion: Intraductal carcinoma is a poor prognostic factor that must be systematically reported in the anatomopathological report. In Senegal, it is often associated with advanced stage, high-grade carcinoma and high PSA levels.
References
[1]
Humphrey, P.A., Moch, H., Cubilla, A.L., Ulbright, T.M. and Reuter, V.E. (2016) The 2016 WHO Classification of Tumors of the Urinary System and Male Genital Organs-Part B: Prostate and Bladder Tumors. European Urology, 70, 106-119. https://doi.org/10.1016/j.eururo.2016.02.028
[2]
Szentirmai, E. and Giannico, G.A. (2020) Intraductal Carcinoma of the Prostate. Pathologica—Journal of the Italian Society of Anatomic Pathology and Diagnostic Cytopathology, 112, 17-24. https://doi.org/10.32074/1591-951X-5-20
[3]
Kato, M., Kimura, K., Hirakawa, A., et al. (2018) Prognostic Parameter for High Risk Prostate Cancer Patients at Initial Presentation. Prostate, 78, 11-16. https://doi.org/10.1002/pros.23438
[4]
Saeter, T., Vlatkovic, L., Waaler, G., et al. (2017) Intraductal Carcinoma of the Prostate on Diagnostic Needle Biopsy Predicts Prostate Cancer Mortality: A Population-Based Study. Prostate, 77, 859-865. https://doi.org/10.1002/pros.23326
[5]
Haffner, M.C., Weier, C., Xu, M.M., et al. (2016) Molecular Evidence That Invasive Adenocarcinoma Can Mimic Prostatic Intraepithelial Neoplasia (PIN) and Intraductal Carcinoma through Retrograde Glandular Colonization. The Journal of Pathology, 238, 31-41. https://doi.org/10.1002/path.4628
[6]
Watts, K., Li, J., Magi-Galluzzi, C. and Zhou, M. (2013) incidence and Clinicopathological Characteristics of Intraductal Carcinoma Detected in Prostate Biopsies: A Prospective Cohort Study. Histopathology, 63, 574-579. https://doi.org/10.1111/his.12198
[7]
Zhang, Y.C., Sun, G.L., Ma, D.L., et al. (2020) The Presence of Intraductal Carcinoma of the Prostate Is Closely Associated with Poor Prognosis: A Systematic Review and Meta-Analysis. Asian Journal of Andrology, 23, 103-108. https://doi.org/10.4103/1008-682X.194817
[8]
Ndoye, M., Niang, L., Gandaho, K.I., Jalloh, M., Labou, I. and Gueye, S. (2014) Advanced Prostate Cancer in Senegal. Diagnostic Aspects at Grand Yoff Hospital. Progress in Urology, 24, 271-275. https://doi.org/10.1016/j.purol.2013.08.317
[9]
Ndiaye, M., Sow, O., Thiam, A., et al. (2020) Prostate Cancer at the Aristidie Le Dantec University Hospital Center in Dakar: Epidemiological Aspects over the Last Five Years. Annals of African Medicine, 14, E4004-E4009.
[10]
Guo, C.C. and Epstein, J.I. (2006) Intraductal Carcinoma of the Prostate on Needle Biopsy: Histologic Features and Clinical Significance. Modern Pathology, 19, 1528-1535. https://doi.org/10.1038/modpathol.3800702
[11]
Varshney, S., Buttirini, G. and Gupta, R. (2002) Incidental Carcinoma of the Gallbladder. European Journal of Surgical Oncology (EJSO), 28, 4-10. https://doi.org/10.1053/ejso.2001.1175
[12]
Varma, M., Delahunt, B., Egevad, L. and Samaratunga, H. (2019) Kristiansen Gintraductal Carcinoma of the Prostate: A Critical Re-Appraisal. Virchows Archiv, 474, 525-534. https://doi.org/10.1007/s00428-019-02544-6
[13]
Robinson, B.D. and Epstein, J.I. (2010) Intraductal Carcinoma of the Prostate without Invasive Carcinoma on Needle Biopsy: Emphasis on Radical Prostatectomy Findings. Journal of Urology, 184, 1328-1333. https://doi.org/10.1016/j.juro.2010.06.017
[14]
Sylla Niang, M., Drame, N., Jalloh, M., et al. (2010) Distribution of Prostate Specific Antigen in a Senegalese Population. Immuno-Analysis & Specialized Biology, 25, 67-71. https://doi.org/10.1016/j.immbio.2010.03.006
[15]
Kato, M., Hirakawa, A., Kobayashi, Y., et al. (2019) The Influence of the Presence of Intraductal Carcinoma of the Prostate on the Grade Group System’s Prognostic Performance. The Prostate, 79, 1065-1070. https://doi.org/10.1002/pros.23818
[16]
Gueye, S.M., Jalloh, M., Labou, I., Niang, L., Kane, R. and Ndoye, M. (2004) Clinical Profile of Prostate Cancer in Senegal. African Journal of Urology, 10, 203-207.
[17]
Loko, F., Hodonou, R., Akpaka, R., Hounnasso, P., Adisso, S. and Akpo, C. (2011) Predictive Value of PSA in the Diagnosis of Prostate Cancer in Beninese Subjects. International Journal of Biological and Chemical Sciences, 5, 515-523. https://doi.org/10.4314/ijbcs.v5i2.72096
[18]
Niang, L., Ndoye, M., Ouattara, A., et al. (2013) Prostate Cancer: What Treatment in Senegal? Progress in Urology, 23, 36-41. https://doi.org/10.1016/j.purol.2012.09.002
[19]
Kabore, F.A., Zango, B., Sanou, A., Yameogo, C. and Kirakoya, B. (2011) Prostate Cancer Outcome in Burkina Faso. Infectious Agents and Cancer, 6, S6. https://doi.org/10.1186/1750-9378-6-S2-S6
[20]
Osiecki, R., Kozikowski, M., Sarecka-Hujar, B., Pyzlak, M. and Dobruch, J. (2023) Prostate Cancer Morphologies: Cribriform Pattern and Intraductal Carcinoma Relations to Adverse Pathological and Clinical Outcomes—Systematic Review and Meta-Analysis. Cancers, 15, Article No. 1372. https://doi.org/10.3390/cancers15051372
[21]
Lindberg, J., Kristiansen, A., Wiklund, P., Grönberg, H. and Egevad, L. (2015) Tracking the Origin of Metastatic Prostate Cancer. European Urology, 67, 819-822. https://doi.org/10.1016/j.eururo.2014.09.006
[22]
McNeal, J.E. and Yemoto, C.E. (1996) Spread of Adenocarcinoma within Prostatic Ducts and Acini. Morphologic and Clinical Correlations. The American Journal of Surgical Pathology, 20, 802-814. https://doi.org/10.1097/00000478-199607000-00003
[23]
Dinerman, B.F., Khani, F., Golan, R., et al. (2017) Population-Based Study of the Incidence and Survival for Intraductal Carcinoma of the Prostate. Urologic Oncology: Seminars and Original Investigations, 35, 673.E9-673.E14. https://doi.org/10.1016/j.urolonc.2017.08.015
[24]
Cohn, J.A., Dangle, P.P., Wang, C.E., et al. (2014) The Prognostic Significance of Perineural Invasion and Race in Men Considering Active Surveillance. BJU International, 114, 75-80. https://doi.org/10.1111/bju.12463
[25]
Ahmad, A.S., Parameshwaran, V., Beltran, L., et al. (2018) Should Reporting of Peri-Neural Invasion and Extra Prostatic Extension Be Mandatory in Prostate Cancer Biopsies? Correlation with Outcome in Biopsy Cases Treated Conservatively. Oncotarget, 9, 20555-20562. https://doi.org/10.18632/oncotarget.24994
[26]
Zareba, P., Flavin, R., Isikbay, M., et al. (2017) Perineural Invasion and Risk of Lethal Prostate Cancer. Cancer Epidemiology, Biomarkers & Prevention, 26, 719-726. https://doi.org/10.1158/1055-9965.EPI-16-0237
[27]
Lee, J.T., Lee, S., Yun, C.J., et al. (2010) Prediction of Perineural Invasion and Its Prognostic Value in Patients with Prostate Cancer. Korean Journal of Urology, 51, 745-751. https://doi.org/10.4111/kju.2010.51.11.745
