Gleason grading system
The Gleason grading system, commonly referred to as the Gleason score, is a vital tool in the assessment of prostate cancer in the United States. This grading system evaluates prostate cancer tissue based on its microscopic appearance, specifically how closely the cancer cells resemble normal prostate cells. The Gleason grade consists of two numbers: the first grade identifies the most prevalent pattern of cells, while the second grade reflects the next most common pattern. Together, these grades form the Gleason score, which ranges from 2 to 10 and indicates the potential aggressiveness of the tumor.
A higher Gleason score typically signifies a more aggressive cancer that is likely to grow and spread more quickly, while a lower score suggests a slower-growing tumor. The Gleason score informs treatment options and helps predict patient outcomes. Importantly, the evaluation process involves a biopsy where samples are sent to a pathologist for analysis, and there are no associated risks with the grading procedure itself. Understanding the Gleason score is crucial for patients and healthcare providers in making informed decisions regarding cancer treatment and management.
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Gleason grading system
DEFINITION: The Gleason grading system, also known as the Gleason score, is the most common system used in the United States to evaluate, or “grade,” prostate cancer. The Gleason grade describes the appearance of prostate cancer tissue when observed under a microscope. The grade assigned describes how closely the tumor cells in the prostate tissue resemble normal prostate cells and can predict how quickly the tumor is expected to grow.
Typically, prostate cancer tissue has different patterns within the cells. The first Gleason grade describes the most common pattern. The second Gleason grade is assigned to the next most common pattern of cells in the tissue. Together, these two numbers combined make the Gleason score.
Cancers diagnosed: Prostate cancer
Why performed: Assigning a Gleason grade or score allows the doctor to predict the behavior of the prostate cancer, meaning whether it will be a slow- or fast-growing tumor. This information can have an impact on the treatment choices available to the patient.
Patient preparation: No patient preparation is needed. This evaluation is performed in a laboratory by a pathologist, a doctor who specializes in identifying diseases by examining tissues and cells to determine if cancer cells are present and, if they are, how aggressive the disease may be.
Steps of the procedure: After the patient undergoes a prostate biopsy, the samples are sent to a pathologist to determine the Gleason grade and score of the prostate cancer tissue.
After the procedure: It may take anywhere from a few days to a couple of weeks to obtain the results. After the results are received, the patient can discuss the best treatment options available based on the type of prostate cancer cells present in the biopsy samples.
Risks: No risks are associated with this procedure.
Results: There are five Gleason grades. Grade 1 appears similar to normal prostate tissue, which means that the tumor is most likely a slow-growing tumor. Grades 2, 3, and 4 reflect increasingly fast-growing tumors. Grade 5 indicates a fast, aggressive prostate cancer. Having any Gleason grade 5 markers in a biopsy or prostate puts the patient at a higher risk of recurrence.
The Gleason score is determined by adding the two Gleason grades together. The Gleason score is a number between 2 and 10 that reflects how closely the cancer cells resemble normal prostate tissue. In general, a low Gleason score suggests less aggressive tumors and a higher Gleason score suggests more aggressive tumors.
Bibliography
Amin, Mahul B. Gleason Grading of Prostate Cancer: A Contemporary Approach. Philadelphia: Lippincott, 2004. Print.
Brimo, Fadi, et al. "Contemporary Grading for Prostate Cancer: Implications for Patient Care." European Urology 63.5 (2013): 892–901. Print.
Delahunt, Brett, et al. "Gleason Grading: Past, Present and Future." Histopathology 60.1 (2012): 75–86. Print.
Epstein, Jonathan I. The Gleason Grading System: A Complete Guide for Pathologists and Clinicians. Philadelphia: Kluwer/Lippincott, 2013. Print.
Pierorazio, Phillip M., et al. "Prognostic Gleason Grade Grouping: Data Based on the Modified Gleason Scoring System." BJU International 111.5 (2013): 753–60. Print.
“What Is a Gleason Score?” Prostate Cancer Foundation, www.pcf.org/about-prostate-cancer/diagnosis-staging-prostate-cancer/gleason-score-isup-grade/. Accessed 4 July 2024.