The gleason grading system for prostate cancer

Abstract

Introduction: Prostate cancer is currently one of the major health problems of men. According to the latest updates provided by the Center of Statistics and Cancer Registry of the Oncology Institute of Republic of Moldova (OIM) during 2000-2009, the number of prostate cancers, diagnosed de novo in the Republic of Moldova, shows a continuous increase from 85 cases for 2000 to 249 cases in 2009. According to mortality rate among the male population it was registered a prostate cancer percentage growth from 4.1% in 2000, up to 8.1% in 2009.

Discussion and results: Prostate cancer is a very common and very unpredictable form of cancer. Mostly the prostate adenocarcinoma is expressed as a multifocal disease. Histological grading of prostate carcinoma is an important step in defining of prognostic and of the therapeutic behavior. Although there are numerous grading system of prostatic carcinomas, the Gleason system represents a special importance, due of reproducibility but also due of utilization in most institutions and in the specialized literature. The Gleason histological grading scheme is based exclusively on the microscopic aspects of tumor glands at low magnification and, in contrast to other grading systems, disregards aspects of cytology. The Gleason system aims to identify two architectural aspects - the primary model, which is predominantly and secondary model. Both models are denoted by 1-5 grade (grade 1 being the most differentiated cancer and grade 5 the most poorly differentiated or undifferentiated carcinoma). It is considered that prognosis of the disease is influenced by both the architectural aspects of primary and secondary, they are added up to give a combined grade Gleason - Gleason score. The cancers with a higher Gleason score are more aggressive and have a worse prognosis.

Conclusion: The diagnosis and staging of prostate cancer is very important for determining treatment and Gleason score calculation can be used for determining the risk of prostate cancer recurrence.