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For example, if the primary tumor grade was 2 and the secondary tumor grade was 3 but some cells were found to be grade 4, the Gleason score would be 2+4=6. This is a slight change from the pre-2005 Gleason system where the second number was the secondary grade (i.e., the grade of the second-most common cell line pattern).
Of note, this system of describing tumors as "well-", "moderately-", and "poorly-" differentiated based on Gleason score of 2–4, 5–6, and 7–10, respectively, persists in SEER and other databases but is generally outdated. In recent years pathologists rarely assign a tumor a grade less than 3, particularly in biopsy tissue. [citation needed]
In uncertain cases, a diagnosis of malignancy can be excluded by immunohistochemical detection of basal cells (or confirmed by absence thereof), [4] such as using the PIN-4 cocktail of stains, which targets p63, CK-5, CK-14 and AMACR (latter also known as P504S).
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3. Another typical Gleason score might be 7 (3+ 4), where the primary pattern has a Gleason grade of 3 and the secondary pattern has a grade of 4. 4. Finally, the highest possible Gleason score is 10 (5 + 5), when the primary and secondary patterns both have the most disordered Gleason grades of 5.
Donald F. Gleason (November 20, 1920 – December 28, 2008) was an American physician and pathologist, best known for devising the "Gleason score" which predicts the aggressiveness of prostate cancer in patients.
3 comments. 2 comments. 4 outdated. 1 comment. 5 Suggested Edits from QMed. 12 comments. Toggle the table of contents. Talk: Prostate cancer staging. Add languages.
The University of Alberta in Edmonton, Alberta, Canada used the stanine system until 2003, when it switched to a 4-point scale. [3] In the United States, the Educational Records Bureau (they administer the "ERBs") reports test scores as stanines and percentiles. The New Zealand Council for Educational Research uses stanines. [4]