Prostatic cancers: understanding their molecular pathology and the 2016 WHO classification

Abstract

Accumulating evidence suggests that prostatic cancers represent a group of histologically and molecularly heterogeneous diseases with variable clinical courses. In accordance with the increased knowledge of their clinicopathologies and genetics, the World Health Organization (WHO) classification of prostatic cancers has been revised. Additionally, recent data on their comprehensive molecular characterization have increased our understanding of the genomic basis of prostatic cancers and enabled us to classify them into subtypes with distinct molecular pathologies and clinical features. Our increased understanding of the molecular pathologies of prostatic cancers has permitted their evolution from a poorly understood, heterogeneous group of diseases with variable clinical courses to characteristic molecular subtypes that allow the implementation of personalized therapies and better patient management. This review provides perspectives on the new 2016 WHO classification of prostatic cancers as well as recent knowledge of their molecular pathologies. The WHO classification of prostatic cancers will require additional revisions to allow for reliable and clinically meaningful cancer diagnoses as a better understanding of their molecular characteristics is obtained.

Cellular and Molecular Progression of Prostate Cancer: Models for Basic and Preclinical Research

“…Notably, PCa incidence and associated mortality are nearly two-thirds and over two times higher, respectively, in African-American (AA) men compared to their Caucasian-American (CA) counterparts [ 2 , 3 ]. PCa follows a defined pattern of cellular progression but exhibits diverse molecular pathobiology making it one of most highly heterogeneous cancers [ 4 , 5 ]. The prostate-specific antigen (PSA) test is the primary detection tool for PCa screening.…”

Carcinosarcoma prostate with osteosarcomatous differentiation: a rare de novo presentation

“…Gleason grade 5 should be assigned for the sarcomatoid component and glandular element if present should be given grade as per usual rules 17. Tumour marker and immunohistochemical analyses of expressions of PSA, prostatic acid phosphatase, HMW-Ck, TP63 and AMACR are very helpful in reaching the final histopathological diagnosis 18. Recently, an erythroblast transformation–specific gene deletion was detected in sarcomatoid and adenocarcinoma component, confirming that these tumours are derived from the prostate epithelium 19.…”

Locally invasive, castrate-resistant prostate cancer in a Pten/Trp53 double knockout mouse model of prostate cancer monitored with non-invasive bioluminescent imaging

“…Necropsy tissue from both the DKO and HET mice showed that tumors had sarcomatoid pathology. This is a rare, undifferentiated and mesenchymal prostate pathology (<1% of prostate cancer tumors) that is considered to be highly aggressive [25][26][27]. The loss of p53 function may be associated with the development of sarcomatoid tumors in patients.…”