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What is Gleason score is used for prognosticating outcome of? and explain in detail?
Ans. D. Prostatic cancer. (Ref. Bailey and Love 26th/pg. 98; 1352)Gleason scoreAdenocarcinomas are also often classified as Gl, 2 or 3, but prostate cancer is an exception with widespread use of the Gleason system. The Gleason system grades prostate cancer according to the degree of differentia- tion of the two most prevalent architectural patterns. The final score is the sum of the two grades and can vary from 2 (1 + 1) to 10 (5 + 5). With the higher scores indicating poorer prognosis.A classification of the histological pattern based on the degree of glandular de-differentiation and its relation to stroma has been devised by Gleason. Prostate cancers exhibit heterogeneity within tissue, and so two histological areas of prostate are each scored between 1 and 5. The scores are added to give an overall Gleason score of between 2 and 10; this (and the volume of the cancer) appears to correlate well with the likelihood of spread and the prognosis.Educational points:Treatment and stage of Ca prostate:# Treatment options for prostate cancer depend on stage of disease, life expectancy of the patient and patient preference# PSA, DRE and biopsy Gleason grade are used to predict pathological stage# Localised cancer can be treated by radical prostatectomy, radiation therapy and active monitoring# Treatment of advanced disease is palliative, and hormone ablation remains the first-line therapy