How to assess the severity of prostate cancer? Talk about risk assessment of prostate cancer

Prostate cancer, referred to as PCA, is the most common malignant tumor of the male reproductive system and the second leading cause of death from malignant tumors in men after lung cancer. With the increase of the aging population and the improvement of diagnostic capabilities, the incidence of prostate cancer patients in my country has gradually increased. Like other malignant tumors, prostate cancer patients will also go through different stages, so how to evaluate the severity of prostate cancer?

Prostate cancer is characterized by slow growth. It is more common in men over 65 years old. At the age of 80, more than 50% of men may have prostate cancer. Early detection of prostate cancer will provide a variety of treatment options, and it is particularly important to clarify the stage of prostate cancer. The severity of prostate cancer patients is usually comprehensively judged based on the Gleason score, TNM score and PSA level.

1. Gleason score

The Gleason score is the most common grading system for prostate cancer, which is based on the morphology of cells in prostate cancer tissue samples. The higher the Gleason score, the higher the pathological grade, and high-grade tumors are more likely to grow and metastasize. The Gleason score is divided into 4 stages. Among them, stage I tumors are only located in the prostate, with a Gleason score of 6 or less; stage II has a higher pathological grade but is still located in the prostate; stage III tumors metastasize to invade the seminal vesicles but not the lymph nodes; stage IV tumors metastasize to other parts such as the lymph nodes and bladder.

2. TNM score

The TNM score, in which T stands for tumor, N stands for node, and M stands for metastasis, refers to the different locations of prostate cancer tumor growth. Doctors score each point and then combine the scores to determine the grade of cancer.

3. PSA level

PSA level is one of the commonly used methods for diagnosing prostate cancer. The PSA level in the blood of prostate cancer patients will increase, and the PSA level will also change over time.

The above three factors are analyzed comprehensively to classify the risk level of prostate cancer into low, medium and high levels. Among them, the low level is PSA level 20ng/ml, Gleason score ≥8, TNM score ≥cT2c.

Therefore, in clinical practice, doctors will select one or more of the following tests to clarify the clinical manifestations of prostate cancer patients, including rectal examination, prostate puncture biopsy, bone scan, pelvic lymph node biopsy, CT scan, seminal vesicle puncture biopsy, etc., and then comprehensively judge the severity of prostate cancer based on the Gleason score, TNM score and PSA level mentioned in the article.