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Updated: Jan 31, 2026
07:16
Isolation of Cancer Stem Cells From Human Prostate Cancer Samples
Published on: March 14, 2014
14.6K
Grading of prostate cancer: a work in progress.
C F Kweldam1, G J van Leenders1, T van der Kwast2
1Department of Pathology, Erasmus MC, Rotterdam, the Netherlands.
Histopathology
|December 20, 2018
Summary
Prostate cancer grading has evolved, but distinguishing grade 4 subpatterns remains challenging. The cribriform pattern shows significant prognostic impact, suggesting areas for improving current prostate cancer grading systems.
Area of Science:
- Uropathology
- Oncology
- Cancer Grading Systems
Background:
- Prostate cancer grading has evolved significantly since the 1980s with PSA testing, shifting detection to earlier stages.
- The Gleason grading system has undergone revisions to enhance prognostic accuracy and reduce interobserver variability.
- Current five-tier systems offer more detailed architectural pattern descriptions for Gleason grades 3-5.
Purpose of the Study:
- To review the historical evolution of prostate cancer grading.
- To describe Gleason subpatterns and their prognostic impact.
- To identify challenges and potential improvements in the current grading system.
Main Methods:
- Literature review of prostate cancer grading systems and prognostic studies.
- Detailed description of Gleason architectural patterns, focusing on grade 4 subpatterns.
- Analysis of evidence regarding the prognostic significance of individual subpatterns.
Main Results:
- Distinguishing common grade 4 subpatterns (ill-formed, fused glands) from grade 3 is difficult, impacting risk stratification.
- The cribriform pattern has demonstrated a prognostic impact exceeding other grade 4 subpatterns.
- Current grading systems still present challenges in precise risk assessment for treatment decisions.
Conclusions:
- Despite advancements, challenges persist in accurately grading prostate cancer, particularly differentiating grade 4 subpatterns.
- The cribriform pattern's significant prognostic value warrants further investigation for integration into grading.
- Improvements in prostate cancer grading are needed to enhance prognostic accuracy and guide therapy selection.
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