Pseudolumen Size and Perimeter in Prostate Cancer: Correlation with Patient Outcome

Abstract

We demonstrated in 2011 that 61% of men with postoperative PSA failure had some cribriform pattern of prostate cancer, versus 16% of nonfailures (OR = 5.89, P < .0001). That study used digitized radical prostatectomy slides from 153 men, 76 failures (≥0.2 ng/mL) matched to 77 nonfailures. The current study's hypothesis: pseudolumen size and shape variability could stratify outcome within histologic patterns (single separate acini, separate acini with undulating lumens, fused small acini, papillary, cribriform). Pseudolumens were filled digitally on image captures from previously annotated specimens. Among all 5 patterns, pseudolumen spaces averaged smaller in failures than nonfailures. After multivariate analysis controlling for stage, age, margin, cancer amount, prostate volume, and presence of individual cells (grade 5), this retained significance only for the undulating-lumens and papillary patterns. In undulating-lumens pattern, PSA failures had smaller mean pseudolumen space sizes (P = .03) but larger perimeters (P = .04), implying more pseudolumen irregularity. In papillary pattern, the number of pseudolumen spaces was higher in failures (P = .015), space size was smaller (P = .11), perimeters were smaller (P = .04), and perimeter/size ratio was higher (P = .02). In conclusion, digitally measured pseudolumen size and shape may associate with outcome.

Dimensional study of prostate cancer using stereological tools

“…Little is known about the nature and variability of dimensional changes in the structure of tumor glands and their relationship with cancer behavior. All factors related (Humphrey, 2004 ; Iczkowski, et al, 2011 ; Tolkach & Kristiansen, 2018 ) to the development of prostate cancer configure the tumor's phenotype, with features that can be quantified by stereology (Mattfeldt et al, 2004 ; Santamaria et al, 2017 , 2018 ).…”

Automated prostate tissue referencing for cancer detection and diagnosis

“…Nuclear morphometry (Nuclear grade) [ 50 – 52 ], reactive stroma (Stromal reaction) [ 53 – 55 ], and retraction clefting (Clefts) [ 56 ] have been reported to be useful for prostate diagnosis and prognosis. In the digital and computerized tissue analyses, structural features describing gland arrangement [ 11 , 36 ] and shape [ 11 , 19 , 36 , 45 ] and the size of gland and lumen (Lumen/gland ratio) [ 12 , 45 , 57 ] have been adopted to characterize tissue. Individual cells also showed a moderate correlation with patient outcomes [ 58 ].…”

Diffusion‐weighted MR spectroscopy of the prostate

“…An interesting aspect of prostate 1 H‐MR spectra is that its signals arise either from metabolites located within cells such as tCho and tCr, or from the metabolites Cit, Spm, and mI that likely occur dominantly in acinar‐luminal fluid 21–23 . Because the size of prostate cells is ˜10 $$$ \upmu \mathrm{m} $$$ 24,25 and the average diameter of acinar‐lumina is ˜100 to 300 $$$ \upmu \mathrm{m} $$$ 3,26 it is expected that the diffusivity of metabolites will reflect their spatial origin.…”