Grading of Prostate Cancer

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What is grading of prostate cancer?

Another step in the diagnostic process is grading the cancer cells - taking a measurement of how fast the tumor is likely to grow and spread. Grading is done in the laboratory with cells taken from the prostate gland during biopsy. The cancer cells are measured by how closely they look like normal cells.

What is the Gleason System for grading cancer?

According to the National Cancer Institute, one way of grading prostate cancer is the Gleason Grading System. The Gleason Grading System is used to evaluate or "grade" prostate cancer cells obtained by needle biopsy. The cells are assigned a number between 1 and 5 - nearly normal cells are Grade 1 and the most abnormal are Grade 5. Then the scores of the two most common cell patterns are added together. Gleason scores range from 2 to 10. The higher the grade, the more aggressive the cancer.

1	Simple round glands, closely packed in rounded masses with well-defined edges.
2	Simple round glands, loosely packed in vague, rounded masses with loosely defined edges.
3A	Medium-sized single glands of irregular shape and irregular spacing with ill-defined infiltrating edges.
3B	Very similar to 3A, but small to very small glands which must not form significant chains or cords.
3C	Papillary and cribriform epithelium in smooth, rounded cylinders and masses; no necrosis.
4A	Small, medium, or large glands fused into cords, chains, or ragged, infiltrating masses.
4B	Very similar to 4A, but with many large clear cells, sometimes resembling "hypernephroma."
5A	No glandular differentiation, solid sheets, cords, single cells, or solid nests of tumor with central necrosis.
5B	Anaplastic adenocarcinoma in ragged sheets.