Revisiting Prostate Biopsy with 2014 ISUP Modified Gleason Score and Gleason Grade – A Cross Section Study

Abstract

Background: Prostatic carcinoma is one of the most common carcinomas among men throughout the world. Gleason score (GS) system is used in reporting and assessing the prognosis of prostatic carcinoma. The GS has undergone modifications. The objective of this study is to evaluate the impact of the new 2014 ISUP Modified Gleason System and Gleason grading (GG) on reporting of prostatic carcinoma.

Methodology: This is a retrospective Study. All cases reported as adenocarcinoma prostate from January 2013 to July 2018 were included in the study. The GS done previously as per 2005 criteria was noted. The GS system and GG were done on the microslides retrieved as per 2015 criteria and compared with that of GS already recorded and also with old risk stratification.

Results: Comparing the GS of 2005 and 2015 criteria, there was a marked decrease (80%) in Gleason score 6; among these cases, 80% cases were graded as score 7, and 20% cases were graded as score 8. There is also a 28.57% decrease in Gleason score 8 and 60% increase in Gleason score 9 due to the new criteria for pattern 4. The GG 1,2,3,4 and 5 constituted 3.03%, 18.18%, 15.15%, 15.15%, and 48.49% of cases respectively.

Conclusion: The new GS and GG has more impact on prognosis of adenocarcinoma prostate as GS 6 has better prognosis and GG gives better risk stratification compared to the previous risk stratification.