Gleason scale gradation interpretation analysis quality

The Gleason scale is a summative assessment of the differentiation of prostate cancer. Based on the indicators of histological analysis, the further course of the disease is planned, the stages of the drug course of treatment are formed. High Gleason scores are associated with negative predictions.

Characteristics of gradation indicators

Thanks to many years of experience in the study of tissue samples obtained as a result of histological analysis, a grading of prostate cancer according to the Gleason scale has been formed. As a result of laboratory probing, it was established: during the period of tissue degeneration into a malignant formation, the primary signs of cells are lost.

Classification of grading steps:

The Gleason score reflects the direct dependence of the regeneration of healthy cells of the prostate gland. High gradation indices indicate the malignancy of the neoplasm (neglect of the disease).

Explanation of indicators

A malignant tumor of the prostate gland is localized in several foci. To determine the gradation, a sample is made from the two largest foci (cells of the first and second levels).

The Glisson sum is formed as a result of the addition of two indicators (the level of gradation of each sample). The generally accepted classification: the minimum indicator is 2 units, the maximum is 10 units. If the Gleason score for prostate cancer varies within 1-2 points, the disease is non-aggressive, the number of homogeneous glands is minimal. In practice, it is almost impossible to determine deviations from the norm. Experts prefer to use "German" standards in the equivalent of 3 to 10 points.

Points total: 6

The score ratio is considered "3 + 3". Corresponds to heterogeneous tumors in the prostate gland, healthy cells occupy a mass fraction.

Cancer cells are characterized by:

• Slow pace of development.
• The growth rate reaches "n-th" sizes, subsequently the development phase fades.
• Localized exclusively in the tumor capsule.
• No metastases.

The prognosis of the disease is favorable, the PSA indicator rises extremely slowly; amenable to drug treatment. An asymptomatic course makes it difficult to detect the disease at an early stage.

Points total: 7

The Gleason score for prostate cancer of 7 points indicates an average degree of tumor neoplasm. The indicator of "3 + 4" points is manifested in the form of atypical cells, the deviation from healthy ones is significant.

Prognosis of the disease: pathology requires immediate treatment, otherwise metastases penetrate into the tissue, followed by spread throughout the body. A limited neoplasm is localized by complete removal of the prostate gland. Additionally, a course of radiation therapy is carried out, often combined with a course of chemotherapy.

Points total: 8

The prognosis of the disease is unfavorable. Tumor formations are characterized by rapid growth rates, metastases affect the lymphatic system, the walls of the tumor capsule are completely destroyed, and damage to neighboring organs (nearby tissues) is observed. PSA is growing exponentially.

Often, the disease is diagnosed at the stage of metastasis, early detection of the disease leaves a chance for a complete recovery of the patient. A score of 8 makes surgery a "waste of time." Staging classification: severe.

Points total: 9

Tumor formation with a combination of points "5 + 4" in comparison "4 + 5" is considered more aggressive. Cancer cells infect epithelial tissues, with subsequent development.

Characteristic features of cancer cells:

• High growth rates.
• Ability to "move" to adjacent organs, to damage tissues.
• The period of metastasis is minimal.

The probability of death is extremely high. Treatment is reduced to prolonging the patient's life; the life cycle period directly depends on the correctly selected course of drug therapy.

It is extremely rare that events develop according to the following scenario: the prostate gland is completely removed (provided that the tumor in the prostate is limited). Radiation therapy is prescribed, with an additional course of hormonal drugs.

Points total: 10

The probability of a positive outcome of therapy is 7-10%, the chance of a relapse remains. At the last stage of the development of the disease, surgical intervention is extremely rare, due to a decrease in the quality of the patient's life. Diagnosing the disease in the early stages helps to inhibit the growth of tumor formation (subject to a well-designed medical course of treatment).

Quality of analysis

The quality of histological analysis directly depends on the following factors:

• Obtaining biological material. An incorrectly performed histological analysis will disorient the specialist who performed the analysis and will subsequently affect the formulation of an accurate diagnosis.
• Professional competence of a specialist.
• The process of taking tissue. Indicators of the state of vital activity of cancer cells during a biopsy and at the time of a surgical operation, as a result, may have different indicators. For the reliability of the results, an additional examination of the patient may be prescribed.

With the introduction of modern diagnostic methods, it became possible to identify prostate cancer at the early stages of development. A Gleason score above 7 is not a sentence; in practice, a lot of cases of successful treatment of patients with indicators of 10 points are known.