Description
Carcinome cribriforme de la prostate
- Artificial intelligence for detection, grading, and prognostication in prostate cancer pathology: A scoping reviewon 23 mars 2026
Histol Histopathol. 2026 Mar 25:25059. doi: 10.14670/HH-25-059. Online ahead of print.ABSTRACTArtificial intelligence (AI) has been transforming many aspects of medical care. In prostate cancer, ongoing progress in AI has improved research and patient care. Recent advances in machine learning and deep learning have produced tools that help diagnose cancer, assess risk, and predict outcomes. In screening, AI-based risk calculators improve detection and help avoid unnecessary biopsies. Deep learning algorithms, particularly convolutional neural networks, have demonstrated expert-level performance in pathology, identifying malignancy and assigning Gleason grades with high accuracy. These tools also streamline workflow, flagging challenging cases for review and quantifying prognostic markers, such as Ki-67 and cribriform patterns. In addition, AI-based models can predict molecular alterations, microsatellite instability, and lymph node metastasis directly from histology images, providing cost-effective alternatives to traditional assays. The development of multimodal models integrates digital pathology and clinical parameters, enabling personalized treatment recommendations and improved outcome prediction. Natural language processing and large language models further expand AI's potential, facilitating information extraction from clinical notes and enhancing patient education. Despite these advances, most studies remain retrospective with heterogeneous endpoints. Performance often drops when models are tested at new sites because of differences in patient populations and slide preparation. Access to large, well-annotated datasets is limited, and technical variation hampers reproducibility. To move toward clinical use, the field needs prospective, multicenter validation, preanalytical and analytical standardization, and clear reporting of failure modes and human oversight. Emerging approaches, including self-supervised pretraining, transformer-based image models, and language-vision systems, are likely to improve generalization and support more personalized care.PMID:41808601 | DOI:10.14670/HH-25-059
Carcinome intracanalaire de la prostate
- Intraductal histiocytes as a simulant of intraductal carcinoma of the prostateon 23 mars 2026
Am J Clin Pathol. 2026 Mar 3;165(3):aqag004. doi: 10.1093/ajcp/aqag004.ABSTRACTOBJECTIVE: Contemporary reporting guidelines require assessment for intraductal carcinoma of the prostate (IDC-P), given its recognition as an adverse prognostic factor. While several benign and malignant mimickers of intraductal carcinoma have been reported and studied, the potential for intraductal aggregates of histiocytes to simulate or complicate assessment of this process has not been addressed in the literature.METHODS: The authors performed a retrospective multi-institutional review of challenging prostate lesions in which intraductal histiocytic aggregates simulated involvement by IDC-P. Pathology reports and slides were reviewed by 3 fellowship-trained genitourinary pathologists, and clinicopathologic features, immunohistochemistry use, and relative difficulty of the diagnosis were assessed.RESULTS: A total of 47 cases of intraductal histiocytes simulating IDC-P were identified, including 27 needle biopsy, 9 transurethral resection, and 6 radical prostatectomy cases. Overall, 19 cases showed histiocytic aggregates in cases with carcinoma, while 28 occurred in otherwise benign settings. Immunohistochemistry was performed in 14 cases for resolution of the diagnosis. When categorized by the authors in terms of difficulty of the diagnosis, 20 of 47 cases were considered "moderate" or "difficult."CONCLUSIONS: Based on their solid appearance spanning an intact duct, aggregates of histiocytes within prostatic ducts may closely simulate IDC-P. Given the prognostic significance of IDC-P, this potential pitfall merits consideration and targeted use of immunohistochemistry in challenging cases.PMID:41819611 | DOI:10.1093/ajcp/aqag004
Critères diagnostiques histologiques
- Association between biochemical and histopathological parameters in the clinical assessment of prostate tumors in a resource-limited setting in northern Cameroonon 23 mars 2026
Cancer Treat Res Commun. 2026 Mar 11;47:101175. doi: 10.1016/j.ctarc.2026.101175. Online ahead of print.ABSTRACTIn low-resource settings, prostate tumors are often diagnosed at advanced stages because of limited access to imaging and histopathological services. Identifying routinely available laboratory biomarkers that could support clinical assessment and referral decisions is therefore of practical importance. This study evaluated the associations between selected biochemical parameters and histopathological diagnoses of prostate tumors in northern Cameroon. An analytical cross-sectional study was conducted among 90 men with suspected prostate tumors at the Islamic Clinic of Ngaoundere. Histopathological findings from prostate biopsy, including Gleason score, were correlated with serum prostate-specific antigen (PSA), creatinine, urea, and alkaline phosphatase (ALP). PSA was analyzed as both a continuous variable and a categorical variable using the standard 4 ng/mL threshold. Elevated creatinine was defined as ≥13 mg/L and urea as >0.5 mmol/L according to laboratory reference ranges. Prostate cancer accounted for 48% of cases and benign prostatic hyperplasia (BPH) for 52%. The median PSA level was 27 ng/mL (range: 3-1706 ng/mL). PSA levels >4 ng/mL were observed in 65.6% of patients and were more frequent in prostate cancer (70.2%) than in BPH (60.5%), without significant discrimination (p = 0.331). Elevated creatinine and urea were found in 53.3% and 48.1% of patients, respectively. PSA, creatinine, and ALP were significantly associated with prostate volume, whereas urea was not. ALP elevation (30%) was not associated with Gleason score. Considerable overlap in biochemical values was observed between malignant and benign conditions. Routinely available biochemical parameters provide complementary information but lack sufficient diagnostic accuracy to distinguish prostate cancer from BPH.PMID:41855628 | DOI:10.1016/j.ctarc.2026.101175
- Perineural Invasion in Radical Prostatectomy Specimens and Its Association with Biochemical Recurrence and Survival in Prostate Cancer: A Systematic Review and Meta-analysison 23 mars 2026
Eur Urol Open Sci. 2026 Feb 12;85:99-110. doi: 10.1016/j.euros.2026.01.018. eCollection 2026 Mar.ABSTRACTBACKGROUND AND OBJECTIVE: Perineural invasion (PNI) in prostate cancer (PC) has been linked to adverse oncological outcomes. The objective of this study was to evaluate the association between PNI identified in radical prostatectomy (RP) specimens and survival outcomes.METHODS: A systematic literature search was conducted in December 2024 using PubMed (MEDLINE), Embase, Scopus, and Web of Science Core Collection databases. We included studies reporting on PNI in RP specimens and its association with primary endpoints (biochemical recurrence [BCR] or BCR-free survival) and/or secondary endpoints (cancer-specific survival [CSS], overall survival, recurrence-free survival, disease-free survival [DFS], or metastasis-free survival).KEY FINDINGS AND LIMITATIONS: A total of 58 studies met the inclusion criteria. A meta-analysis of 40 studies (27 030 patients) demonstrated that PNI was associated with BCR (pooled hazard ratio [HR] 1.40, 95% confidence interval [CI] 1.28-1.52; p < 0.001). Further analyses showed that PNI was linked to worse CSS (n = 903; pooled HR 2.9, 95% CI 1.1-8.1; p = 0.048). The association with DFS was not statistically significant (n = 1008; pooled HR 1.8, 95% CI 0.7-4.3; p = 0.1). The main limitation is the reliance on predominantly retrospective studies with small samples and high risk of bias.CONCLUSIONS: Our findings indicate that PNI identified in RP specimens is associated with higher risk of BCR, as well as worse CSS, which underscores its relevance as a prognostic factor in PC.PATIENT SUMMARY: We found that detection of cancer cells around nerves, which is called perineural invasion (PNI), in specimens after surgery to remove the prostate, is linked to a higher chance of worse survival outcomes in prostate cancer. Men with PNI were more likely to experience biochemical recurrence and had worse cancer-specific survival. PNI may help in identifying patients at higher risk after surgery who could benefit from closer follow-up or additional treatment. However, more high-quality studies are needed to confirm its role in guiding long-term care.PMID:41726852 | PMC:PMC12924184 | DOI:10.1016/j.euros.2026.01.018
- Cancer-Specific Mortality in Rare Histological Subtypes of Prostate Cancer: Radical Prostatectomy Versus Radiation Therapyon 23 mars 2026
Ann Surg Oncol. 2026 Feb 20. doi: 10.1245/s10434-026-19245-5. Online ahead of print.ABSTRACTBACKGROUND: Cancer-specific mortality (CSM) rates in patients with rare histological prostate cancer subtypes after treatment with radical prostatectomy (RP) versus radiation therapy (RT) are largely unknown.METHODS: Relying on the Surveillance, Epidemiology, and End Results database (2004-2020), we identified patients with five prostate cancer subtypes treated with RP or RT. Kaplan-Meier analyses and Cox regression models addressed CSM.RESULTS: Of 427,055 patients, 425,692 (99.68%) harbored acinar, 855 (0.20%) ductal, 324 (0.08%) mucinous, 54 (0.01%) signet ring cell adenocarcinoma, and 130 (0.03%) neuroendocrine carcinoma. Of those, 250,910 (59%), 592 (69%), 262 (81%), 34 (63%), and 34 (26%) were treated with RP, respectively. Five-year cancer-specific survival rates after RP versus RT were 99.2 versus 97.1% in acinar; 96.3 versus 87.1% in ductal; 98.7 versus 92.1% in mucinous; 97.0 versus 94.7% in signet ring cell; and 59.4 versus 20.5% in neuroendocrine carcinoma. In univariable Cox regression models, RP was associated with a lower CSM rate in acinar (hazard ratio [HR] 0.28; p < 0.001), ductal (HR 0.25; p < 0.001), and neuroendocrine (HR 0.36; p < 0.001), but not in mucinous (p = 0.052) and signet ring cell carcinoma (p = 0.8). After multivariable adjustment, RP remained an independent predictor of lower CSM in acinar (HR 0.35; p < 0.001), ductal (HR 0.30; p < 0.001), and neuroendocrine carcinoma (HR 0.53; p = 0.042).CONCLUSIONS: Higher CSM was recorded after RT in acinar, ductal, and neuroendocrine carcinoma. Conversely, no differences in CSM were identified when RP was compared with RT in mucinous and signet ring cell adenocarcinoma.PMID:41718902 | DOI:10.1245/s10434-026-19245-5
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