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Related Experiment Video

Updated: May 26, 2026

Establishment and Evaluation of a Risk Prediction Model for Pathological Escalation of Gastric Low-Grade Intraepithelial Neoplasia
03:05

Establishment and Evaluation of a Risk Prediction Model for Pathological Escalation of Gastric Low-Grade Intraepithelial Neoplasia

Published on: February 16, 2024

Gleason grading: past, present and future.

Brett Delahunt1, Rose J Miller, John R Srigley

  • 1Department of Pathology and Molecular Medicine, Wellington School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand. bd@wnmeds.ac.nz

Histopathology
|January 4, 2012
PubMed
Summary
This summary is machine-generated.

The Gleason grading system for prostate cancer has been modified, but recent changes lack supporting data. The 2005 International Society of Urological Pathology (ISUP) classification should be used until outcome studies validate further alterations.

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Last Updated: May 26, 2026

Establishment and Evaluation of a Risk Prediction Model for Pathological Escalation of Gastric Low-Grade Intraepithelial Neoplasia
03:05

Establishment and Evaluation of a Risk Prediction Model for Pathological Escalation of Gastric Low-Grade Intraepithelial Neoplasia

Published on: February 16, 2024

Area of Science:

  • Urological Pathology
  • Oncology
  • Cancer Grading Systems

Background:

  • The Gleason grading system, developed in 1966 and refined in 1974, is a standard for prostatic adenocarcinoma.
  • Modifications were recommended in 2005 by the International Society of Urological Pathology (ISUP), leading to tumor upgrading.
  • While some studies show better concordance with the modified system, its widespread adoption precedes robust validation.

Purpose of the Study:

  • To evaluate the validity and impact of modifications to the Gleason grading system.
  • To assess the evidence supporting recent suggestions for further changes to the Gleason classification.
  • To provide recommendations on the continued use of the Gleason scoring classification.

Main Methods:

  • Review of the historical development and modifications of the Gleason grading system.
  • Analysis of studies comparing classical Gleason (CG) grading with the modified ISUP classification.
  • Evaluation of the data supporting recent proposed changes, including the classification of cribriform glands.

Main Results:

  • The 2005 ISUP modifications led to significant tumor upgrading and have been correlated with clinical outcomes.
  • Recent proposals, such as reclassifying cribriform glands as Gleason pattern 4, lack supporting validation data.
  • Despite limited evidence, the modified Gleason system has achieved widespread clinical use.

Conclusions:

  • The 2005 ISUP Gleason classification should be maintained in its current format due to a lack of validating data for further modifications.
  • Future alterations to the Gleason scoring system should only be implemented when supported by robust tumor-related outcome studies.
  • Continued critical evaluation of grading system modifications is essential for accurate prostate cancer prognostication.