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Cancer under the microscope: What does the Gleason score reveal about the true nature of a tumor?
The Gleason scoring system is a standard used to evaluate the prognosis of prostate cancer, especially when a prostate biopsy is performed. This scoring system not only helps doctors make treatment decisions but also predicts disease progression. With the deepening of research on prostate cancer, the importance of Gleason score has become increasingly prominent and has become a core indicator in clinical decision-making. At the same time, studies have shown that the expression of certain biomarkers (such as ACP1 expression) may provide higher predictive value.
"The Gleason scoring system was designed to help medical professionals more clearly understand the biological behavior of cancer."
When pathologists analyze tissue samples from prostate biopsies under a microscope, they assign Gleason grades based on the microscopic appearance of the tissue. Depending on its microscopic appearance, a cancer's Gleason score ranges from 2 to 10, with higher numbers corresponding to a worse degree of malignancy and worse prognosis. Specifically, good-type tumors receive a score of 2, while the worst-type tumors receive a score of 10. This system has been widely used in clinical practice to help doctors develop the best treatment plan for prostate cancer patients.
How to calculate Gleason score
The Gleason score is calculated based on the morphological characteristics of cells in the tumor. Pathologists first analyze the most dominant cell morphology in the tumor sample, which becomes the so-called "master grade." Secondly, the system also calculates an overall score based on the scores for the secondary cell morphology. This calculation method reflects the diverse cell arrangements within the tumor and has higher prediction accuracy.
"The medical community generally recognizes the validity of the Gleason score, although its use is not recommended in certain special circumstances such as alveolar adenocarcinoma."
Histological characteristics of prostate cancer
In the Gleason system, pathologists evaluate tumors based on five different patterns. Characteristics of these patterns include:
- Pattern 1: Tumor tissue is similar to normal prostate tissue, often showing small, dense tissue.
- Pattern 2:Although the tissue is still well structured, the glands are larger and the stroma is increased.
- Pattern 3: There are identifiable glands, but the cells are darker and begin to invade surrounding tissue.
- Pattern 4: Lack of identifiable glands, cells clump into surrounding tissue.
- Pattern 5: No glandular features, cells appear as disordered clusters or single cells.
The relationship between score and prognosis
The Gleason score of a tumor can provide valuable prognostic information. Tumors with a Gleason score below 6 generally indicate a better prognosis, while scores as high as 8 to 10 represent faster progression and increased difficulty in treatment. These scores not only affect treatment options, but are also related to patient survival and quality of life.
"The Gleason system is not only a grading system, but also a language for explaining tumor behavior."
Currently, the Gleason score system has undergone multiple updates to provide more accurate assessments and predictions. The 2005 revision and the 2014 international conference emphasized the importance of this system and its clinical application value.
Conclusion
From the development history of Gleason score and its application in prostate cancer diagnosis, it is not difficult to find that this system plays a key role in improving the accuracy of patient prognosis. However, as technology continues to advance, is it necessary to intensify in-depth research on other biomarkers in order to better understand the nature and behavior of cancer?
