ArticleModern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc2013
Cytoplasmic PTEN protein loss distinguishes intraductal carcinoma of the prostate from high-grade prostatic intraepithelial neoplasia.
Article in Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 1 of them a synthesis that pooled it.
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Who cites it
53 citing papers in PubMed, 1 synthesis or guideline pooled it, 154 citations in OpenAlex.
- The Genitourinary Pathology Society and International Society of Urological Pathology Joint Expert Consultation Recommendations on intraductal carcinoma of the prostate.Histopathology · 2026Guideline
- Cribriform and intraductal carcinoma in prostate cancer - implications for risk stratification and therapeutic decision-making.Nature reviews. Urology · 2026Review
- Prognostic value of cribriform pattern and intraductal carcinoma of the prostate after radical prostatectomy: A systematic review and meta-analysis using contemporary consensus recommendations.Prostate cancer and prostatic diseases · 2026Review
- Atypical intraductal proliferation in prostate biopsy - a diagnostic grey zone with clinical implications.Nature reviews. Urology · 2026Review
- Combined MYC Activation and PTEN Loss Drives Molecular Features of Aggressive Preinvasive Lesions in Mouse Prostate.Molecular cancer research : MCR · 2026Article
- Intraductal carcinoma of the prostate: A comprehensive literature review focused on grading challenges and controversies.Histology and histopathology · 2025Review
- International Society of Urological Pathology Consensus on Cancer Precursor Lesions. Working Group 1: The Prostate.The American journal of surgical pathology · 2025Article
- Label-free histological identification of intraductal carcinoma of the prostate using texture analysis-based multimodal stimulated Raman scattering microscopy.Scientific reports · 2025Article
- Morphologic and clinical spectrum of large gland lesions of the prostate.Pathologie (Heidelberg, Germany) · 2025Review
- [Morphologic and clinical spectrum of large gland lesions of the prostate. German version].Pathologie (Heidelberg, Germany) · 2025Review
- Identification of intraductal-to-invasive spatial transitions in prostate cancer: proposal for a new unifying model on intraductal carcinogenesis.Histopathology · 2025Article
- Article
- The Emerging Predictive and Prognostic Role of Aggressive-Variant-Associated Tumor Suppressor Genes Across Prostate Cancer Stages.International journal of molecular sciences · 2025Review
- Distinct patterns of biomarker expression for atypical intraductal proliferations in prostate cancer.Virchows Archiv : an international journal of pathology · 2024Article
- GRIN3A: A biomarker associated with a cribriform pattern and poor prognosis in prostate cancer.Neoplasia (New York, N.Y.) · 2024Article
- Intraductal Carcinoma of the Prostate versus Simulants: A Differential Diagnosis Growing in Clinical Impact.Cancers · 2024Review
- Molecular complexity of intraductal carcinoma of the prostate.Cancer medicine · 2024Review
- Review
- Predicting Prostate Cancer Molecular Subtype With Deep Learning on Histopathologic Images.Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc · 2023Article
- Cribriform Patterned Lesions in the Prostate Gland with Emphasis on Differential Diagnosis and Clinical Significance.Cancers · 2022Review
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Authors and funding
8 authors at 2 institutions in 2 countries.
Funding
Abstract
Intraductal carcinoma of the prostate is a marker of aggressive disease. However, intraductal carcinoma exists on a morphologic continuum with high-grade prostatic intraepithelial neoplasia (PIN) and distinguishing intraductal carcinoma from PIN is a common diagnostic dilemma with significant clinical implications. We evaluated whether immunostains for PTEN and ERG can sensitively identify intraductal carcinoma and accurately distinguish it from high-grade PIN. A combined immunostain for PTEN, ERG, p63 and CK903 was developed and validated. Radical prostatectomy specimens with lesions meeting criteria for intraductal carcinoma (n=45), intraductal cribriform proliferations falling short of intraductal carcinoma (n=15), and PIN lesions (n=39) were retrospectively identified and assessed for PTEN and ERG. Cytoplasmic PTEN loss was identified in 84% (38/45) of the intraductal carcinoma and 100% (15/15) of intraductal cribriform proliferation cases. In contrast, cytoplasmic PTEN loss was never observed in PIN (0/39; P<0.0001). Of the 53 cases of intraductal carcinoma or intraductal cribriform proliferation with cytoplasmic PTEN loss, it was homogeneously lost in 42 cases (79%). Weak, focal nuclear positivity for PTEN was retained in 31 of these 42 cases (74%). ERG expression was identified in 58% (26/45) of intraductal carcinoma and 67% (10/15) of intraductal cribriform proliferations compared with 13% (5/39) of PIN. Concordance between the PTEN/ERG status of the intraductal carcinoma lesions and the concurrent invasive carcinoma was high (>95% and P<0.0001 for each), and substantially less for PIN and the concurrent invasive tumor (83% for PTEN and 67% for ERG; P=NS for each). Cytoplasmic PTEN loss occurs in the majority of intraductal carcinoma and intraductal cribriform proliferation cases. Cytoplasmic PTEN loss was never observed in PIN (100% specificity). Our study identifies PTEN loss as a potentially useful marker to distinguish intraductal carcinoma from PIN and provides a plausible molecular explanation for why intraductal carcinoma is associated with poor prognosis.
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