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Gleason Score question

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Posted 12/2/2009 3:51 PM (GMT 0)
Howdy. I started reading the Strum book.

In it, he mentions the Gleason score for each positive core.

I thought the Gleason score consists of one pair of numbers (often found in your signatures).

Let's say 3 cores are positive. Does this mean there are 3 Gleason pairs?

Are there individual Gleason scores for each positive core and some overall Gleason score?

Mel

Posted 12/2/2009 3:57 PM (GMT 0)

For each core, the first number is the primary description of what most of the cells in the sample look like.

The second number is the secondary description...of the second most common occurring pattern of cells.

Rarely, a third, terciary (did I spell that right?) number is also given...it gives more info, but isn't frequently used.

So, the order of the numbers is important.  A 3+4 means there is more 3 than anything else, and after the 3's there is more 4 than anything else.  Obviously, that is better than 4+3.

The book gives a image of what each Gleason number "looks like."

good?


Post Edited (Casey59) : 12/2/2009 9:02:58 AM (GMT-7)

Posted 12/2/2009 4:02 PM (GMT 0)

Casey:

No, not quite good. I understand the Gleason Score. What is confusing me are the signatures that people use. They might say 5 out of 12 cores positive, Gleason 3+4.

But isn't there a Gleason for each positive core (that answer is yes)? But is there an overall Gleason score? If not, shouldn;t the signature have 5 Gleason scores in this example?

Mel

Posted 12/2/2009 4:18 PM (GMT 0)
I understand your question, but ya know...I'm drawing a blank right now.  If I was home, I would pull out my own biopsy report to look at it, but I'm away on business this week.

 

But no worries, I'm confident that within 10 minutes you will get 10 other responses in this "chat room" forum...

Posted 12/2/2009 4:40 PM (GMT 0)
Your Gleason score will be the worst that they may find. For example say you take 12 cores and 5 are positive. Perhaps 4 of those cores may show Gleason 3+3 and just one of those cores shows Gleason 3+4. If that is the case you are a Gleason 7 (3+4).
Posted 12/2/2009 4:43 PM (GMT 0)
Since most of the time they are punching the same tumor, the gleason for the cores will generally be the same. The final gleason score generally is a predominant Gleason type. The path may state a third Gleason found, but they will rate the overall agrresiveness of the tumor as one gleason score.
Posted 12/2/2009 7:06 PM (GMT 0)
With the Prostate being the size of a walnut, 12 core samples will mean that these are very close in proximity to each other. The worst score is the one that concerns you and the Dr's as it will spread

So for example knowing that one core is a 3+4 and all the others are 3+3 means little in ones corrective action path

In some cases a higher score is reported in the pathology as a more cancer stricken cell may be found, which was not taken during the Biopsy
Posted 12/2/2009 8:00 PM (GMT 0)
Compiler, my husband had 2 out of 10 positive cores - one was a Gleason 3+3 and the other a Gleason 3+4.  The urologist said the overall Gleason score is always the highest - in your case and my husband's, Gleason 7. This is considered moderate or intermediate in terms of aggressiveness.  If you choose surgery, the path report will assign a final Gleason score which may be different than the biopsy. 
Posted 12/2/2009 8:04 PM (GMT 0)
I had four + cores, one a 5, two 6's, and a (3+4) 7. In my ingnorance I figured, let's see, that averages out to a 6! Nope, they call your final score on whichever core gives the highest value.

Steve
Posted 12/2/2009 8:38 PM (GMT 0)
Riverbend has it correct. Your clinical Gleason score is the highest of all your positive samples. So if you have four positive cores that were 3+3, 3+3, 4+3, and 3+3, your clinical Gleason is 4+3. You should base your decisions on the highest grade found. You should only use the one score, and you won't need the rest for their Gleason value's. What you may want to track, is how much of each core was positive (shown in percentages).

As Casey states, sometimes there is a tertiary score given, but unless it is in your biopsy document, you don't have one.

Tony
Posted 12/2/2009 9:05 PM (GMT 0)

Compiler, I had 5 out of 28 positive in July (RRP in Aug) with 2 gleason 8, 2 gleason 7 and one Gleason 6.  - Pathologist called it 4+4 = 8.  Your biopsy report seems pretty "average" to me.  I would trade you in a minute.  You'll be OK, think positive cause you have a lot of options now.  Old Sailor 

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