Prostatic adenocarcinoma: reproducibility and correlation with clinical stages of four grading systems

One hundred cases of adenocarcinoma of the prostate were independently examined by light microscopy by three pathologists and graded according to the Gleason, Mostofi, Böcking, and MD Anderson systems (MDAH). The results were compared in order to establish which one of these classifications was the most reproducible and then correlated to the clinical stage in order to determine how accurately each classification can predict the spread of the tumors. The MDAH system, based on the percentage of gland formation in the tumor, was the easiest to use and most reproducible system. On the other hand, the Mostofi and the Böcking systems had the best correlation between grade and stage while the MDAH system had the worst. The Böcking system was the best grading system when reproducibility and accuracy in predicting the prognosis were both taken into account.