Pathological diagnosis and grading of prostate cancer

Prostate cancer is the most common malignant tumor of the male reproductive system, and it often occurs in the atrophic posterior lobe of the prostate. There may be no obvious symptoms in the early stage. As the tumor grows, urinary tract obstruction symptoms such as dysuria, thin urine stream, and slow urine flow gradually appear. In the late stage of the disease, metastatic symptoms and chronic wasting symptoms such as hematuria, anemia, weight loss, and fatigue appear. So what are the pathological diagnostic grades of prostate cancer?

Gleason 1: Cancerous tissue is extremely rare. It has clear boundaries, expansive growth, and almost no invasion of the matrix; the cancerous alveoli are simple, mostly round, medium-sized, and closely arranged together, and the cytoplasm of cancer cells is very similar to that of benign epithelial cells.
Gleason 2: Cancerous tissue is rare. It mostly occurs in the transitional zone of the prostate. The tumor boundary is not very clear. The cancerous acini are separated by the matrix and are simple round in shape. The sizes and shapes may vary and they may be irregular and loosely arranged.
Gleason 3: The most common cancer tissue. It mostly occurs in the peripheral area of ​​the prostate. Its most important feature is invasive growth. The cancer acini vary in size and shape, with large and red nucleoli and alkaline staining in the cytoplasm.
Gleason 4: The cancer tissue is poorly differentiated and grows invasively; the cancer alveoli fuse together irregularly to form tiny papillary or cribriform shapes with large and red nucleoli; the cytoplasm may be alkaline or gray.
Gleason 5: The cancer tissue is extremely poorly differentiated. Its borders may be regular circles or irregular shapes, accompanied by invasive growth; the growth form is a sheet-like single cell type or a comedone cancer type, accompanied by necrosis; the cancer cell nucleus is large, the nucleolus is large and red, and the cytoplasm staining may vary.