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  Gleason Grading System Gleason grade  Lower grades are associated with small,closely packed glands. Cells spread out and lose glandular architecture as grade increases. Gleason score is calculatedfrom grade as described in the text. From Wikipedia, the free encyclopedia The Gleason Grading system  is used to help evaluate the prognosis of men withprostate cancer . Together with other parameters, it is incorporated into a strategy of  prostate cancer staging which predicts prognosis and helps guide therapy. A Gleason score is given to prostate cancer based upon its microscopic appearance. [1]  Cancerswith a higher Gleason score are more aggressive and have a worse prognosis. Contents   [hide] 1 Process2 Grades and scores3 Patterns 1 through 54 Primary, secondary, and tertiary5 History6 References7 External links Process [edit]Most often, a urologist or radiologist will remove a cylindrical sample (biopsy) of  prostate tissue through the rectum, using hollow needles, and biomedical scientists in a Histology laboratory prepare microscope slides for H&E and Immunohistochemistry for diagnosis by a pathologist.  After a prostate is removed in surgery, a pathologist will slice the prostate for a final examination. Grades and scores [edit]The pathologist after a low microscopic examination assigns a Gleason score - based on the sum of two numbers: the first number is the scoreof the most common tumor  pattern, the second number is the score of the second most common pattern. If there are three patterns the firstnumber is the most common and the second is the one with the highest grade. For example, if the most common tumor pattern was grade 3,but some cells were found to be grade 4, the Gleason Score would be 3+4 = 7. This is a slight change to the pre-2005 Gleason system wherethe second number was the grade of the second most common cell line. [2]  The Gleason Grade is a summation into low, intermediate or highgrades based upon the Gleason Score which is interpreted from the Gleasons pattern. The Gleason Score ranges from 2 to 10, with 10 having ArticleTalkReadEditView history Search Main pageContentsFeatured contentCurrent eventsRandom articleDonate to WikipediaWikimedia ShopInteractionHelp About WikipediaCommunity portalRecent changesContact pageToolsPrint/exportLanguagesDeutschEspañolFrançais   Lietuvių Nederlands 日本語 PolskiPortuguêsРусскийEdit linksCreate accountLog in Do you need professional PDFs? Try PDFmyURL!  Gleason Pattern 3. H&E stain.Gleason pattern 4. H&E stain.Gleason pattern 4 (left of image) andGleason pattern 5 (right of image). H&Estain. the worst prognosis. For Gleason Score 7, a Gleason 4+3 is a more aggressive cancer than a Gleason 3+4. Also, there is not really anydifference between the aggressiveness of a Gleason Score 9 or 10 tumor.The low grade tumors are those with a score of 5 or below ;intermediate grade with a score of 6 & high grade of 7 or more till 10. This is a prognostic scoring system. Patterns 1 through 5 [edit]Gleason patterns are associated with the following features:Pattern 1 - The cancerous prostate closely resembles normal prostate tissue. The glands aresmall, well-formed, and closely packed. This corresponds to a well differentiated carcinoma.Pattern 2 - The tissue still has well-formed glands, but they are larger and have more tissuebetween them, implying that the stroma has increased. This also corresponds to a moderatelydifferentiated carcinoma.Pattern 3 - The tissue still has recognizable glands, but the cells are darker. At highmagnification, some of these cells have left the glands and are beginning to invade thesurrounding tissue or having an infiltrative pattern. This corresponds to a moderately differentiatedcarcinoma.Pattern 4 - The tissue has few recognizable glands. Many cells are invading the surroundingtissue in neoplastic clumps. This corresponds to a poorly differentiated carcinoma.Pattern 5 - The tissue does not have any or only a few recognizable glands. There are often justsheets of cells throughout the surrounding tissue. This corresponds to an anaplastic carcinoma.In the present form of the Gleason system, prostate cancer of Gleason pattern 1 and 2 are rarelyseen. Gleason pattern 3 is by far the most common. Thus a Gleason score 3+3=6 cancer is to beregarded as LOWEST grade seen in common clinical practice, and indeed these cancers usuallyhave rather good prognoses. Primary, secondary, and tertiary [edit] A pathologist examines the biopsy specimen and assigns a score to the observed patterns of thetumor.Primary grade: assigned to the dominant pattern of the tumor (has to be greater than 50% of thetotal pattern seen).Secondary grade: assigned to the next most frequent pattern (has to be less than 50%, but atleast 5%, of the pattern of the total cancer observed).These grades are then added to obtain the final Gleason score.Increasingly, pathologists provide details of the tertiary component. This is where there is a smallcomponent of a third (generally more aggressive) pattern. So there could be a Gleason 3+4 with atertiary component of pattern 5 - this would be considered to be more aggressive than a prostatecancer that was Gleason 3+4 with no tertiary pattern 5. Although it is debatable as to what the full Do you need professional PDFs? Try PDFmyURL!  [hide]v  · t  · e  · extent the tertiary component has on the aggressiveness of a cancer. History [edit]The scoring system is named after Donald Gleason, a pathologist at the Minneapolis Veterans Affairs Hospital who developed it with other colleagues at that facility in the 1960s. [3][4]  In 2005 the Gleason system was altered by the International Society of Urological Pathology. Thecriteria were refined and the attribution of certain patterns changed. [5]  It has been shown that this 'modified Gleason score' has higher performance than the srcinal one, and is currently assumed standard in urological pathology. In this form, it remains an important tool. References [edit] 1. ^   Male Genital Pathology . Retrieved 2009-05-13.2. ^  Epstein JI, Allsbrook WC Jr, Amin MB, Egevad LL; ISUP Grading Committee. The 2005 International Society of Urological Pathology (ISUP)Consensus Conference on Gleason grading of prostatic carcinoma. Am J Surg Pathol 2005;29(9):1228-42.3. ^  Manage Account - Modern Medicine4. ^  Gleason, D. F. (1977). The Veteran's Administration Cooperative Urologic Research Group: histologic grading and clinical staging of prostaticcarcinoma . In Tannenbaum, M. Urologic Pathology: The Prostate . Philadelphia: Lea and Febiger. pp. 171–198. ISBN 0-8121-0546-X. 5. ^  Epstein JI, Allsbrook WC Jr, Amin MB, Egevad LL. (2005.) The 2005 International Society of Urological Pathology (ISUP) Consensus Conferenceon Gleason Grading of Prostatic Carcinoma, Am J Surg Pathol, 29(9):1228-42. External links [edit]Thorson, Phataraporn; Humphrey, Peter A. (2000). Minimal Adenocarcinoma in Prostate Needle Biopsy Tissue .  American Journal of Clinical Pathology    114  (6): 896–909. doi:10.1309/KVPX-C1EM-142L-1M6W. PMID 11338479. Pathology slides and explanation. [Free] WHO, Geneva Foundation for Medical Education and Research, Prostate cancer, Gleason score. 51 images. Pathology: Tumor , Cancer  and Oncology (C00–D48, 140–239) ConditionsBenign tumors Hyperplasia  · Cyst  · Pseudocyst  · Hamartoma  ·Malignant progression Dysplasia  · Carcinoma in situ  · Cancer   · Metastasis  ·Topography Head/Neck (Oral, Nasopharyngeal)  · Digestive system  · Respiratory system  · Bone  · Skin  · Blood  · Urogenital  · Nervous system  · Endocrine system  ·Histology Carcinoma  · Sarcoma  · Blastoma  · Papilloma  ·  Adenoma  ·Other  Precancerous condition  · Paraneoplastic syndrome  ·Staging /grading TNM  ·  Ann Arbor   · Prostate cancer staging  · Gleason Grading System · Dukes classification  ·Carcinogenesis Cancer cell  · Carcinogen  · Tumor suppressor genes/oncogenes  · Clonally transmissible cancer   · Oncovirus  · Cancer bacteria  ·Misc. Research  · List of oncology-related terms  · History  · Cancer pain  · Cancer and nausea  · M: NEOtsoc, mrkrtumr , epon, paradrug (L1i/1e/V03) Categories: Cancer stagingHistopathologyUrologyMedical scoring system Do you need professional PDFs? Try PDFmyURL!  Privacy policyAbout WikipediaDisclaimersContact WikipediaDevelopersMobile viewThis page was last modified on 25 March 2014 at 17:28.Text is available under the Creative Commons Attribution-ShareAlike License; additional terms may apply. By using this site, you agree to the Terms of Use and Privacy Policy. Wikipedia® is a registered trademark of the Wikimedia Foundation, Inc., a non-profit organization. Do you need professional PDFs? Try PDFmyURL!


Jul 23, 2017


Jul 23, 2017
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