Montironi Rodolfo, Cimadamore Alessia, Cheng Liang, Lopez-Beltran Antonio, Scarpelli Marina
1 Section of Pathological Anatomy, Polytechnic University of the Marche Region, School of Medicine, United Hospitals, Ancona, Italy.
2 Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, USA.
Int J Biol Markers. 2018 Nov;33(4):331-334. doi: 10.1177/1724600818781296. Epub 2018 Jun 27.
The Gleason grading system is among the most important prognostic factors in patients with prostate cancer. From the 2005 to the 2014 consensus conferences, organized by the International Society of Urological Pathology, the morphologic criteria for the identification of the Gleason patterns were redefined, thus resulting in the shrinkage of the Gleason pattern 3. This led to the expansion of the Gleason pattern 4. The newly proposed grade group system reduces the Gleason scores of prostate cancer to the lowest number, each associated with a unique behavior from the prognostic point of view. The advantage is that the simplified system with five groups allows for a more accurate stratification of the patients in comparison with the Gleason system. Cribriform, fused, ill-defined and glomeruloid glands are part of the histologic spectrum of the Gleason pattern 4. Cribriform morphology has a prognosis that is worse in comparison with the other non-cribriform Gleason 4 patterns. One of the major implications of the cribriform growth is that it precludes a patient from choosing active surveillance.
格里森分级系统是前列腺癌患者最重要的预后因素之一。在国际泌尿病理学会组织的2005年至2014年共识会议上，重新定义了识别格里森模式的形态学标准，从而导致格里森模式3缩小。这导致了格里森模式4的扩大。新提出的分级组系统将前列腺癌的格里森评分降至最低数字，从预后角度来看，每个数字都与一种独特的行为相关。其优点是，与格里森系统相比，这个简化的五组系统能够对患者进行更准确的分层。筛状、融合状、边界不清和肾小球样腺体是格里森模式4组织学谱的一部分。与其他非筛状的格里森4模式相比，筛状形态的预后更差。筛状生长的一个主要影响是它使患者无法选择主动监测。
