AIMS: The Gleason scoring (GS) system underwent revision at the International Society of Urological Pathology (ISUP) conference in 2005.
It is not known how uropathologists have interpreted its recommendations.
METHOD AND RESULTS: A web-based survey to European Network of Uropathology members received replies from 266 pathologists in 22 countries. 89% claimed to follow ISUP recommendations. Key areas of disagreement included the following. Smoothly rounded cribriform glands were assigned Gleason pattern (GP) 3 by 51% and 4 by 49%. Necrosis was diagnosed as GP 5 by 62%. Any amount of secondary pattern of higher grade of needle biopsies was included in the GS by 58%. Tertiary GP of higher grade on needle biopsies was included in the GS by only 58%. If biopsy cores were embedded separately, only 56% would give a GS for each core/slide examined. 68% would give a concluding GS and the most common method was a global GS (77%). Among those who blocked multiple biopsy cores together, 46% would only give an overall GS for the case.
CONCLUSION: Misinterpretation of ISUP 2005 is widespread and may explain the variation in Gleason scoring seen. Clarity and uniformity in teaching ISUP 2005 recommendations is necessary.
Written by:
Berney D, Algaba F, Camparo P, Compérat E, Griffiths D, Kristiansen G, Lopez-Beltran A, Montironi R, Varma M, Egevad L. Are you the author?
Queen Mary, University of London, London, UK.
Reference: Histopathology. 2013 Sep 14. Epub ahead of print.
doi: 10.1111/his.12284
PubMed Abstract
PMID: 24102975
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