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Clinical implications of changing definitions within the Gleason grading system

机译：在格里森分级系统中更改定义的临床意义

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Remarkably, more than 40 years after the inception of the Gleason grading system, it remains one of the most powerful prognostic predictors in prostate cancer. Gleason's original grading system, however, has undergone significant revision over the years, first by Gleason and his colleagues, and most recently at the 2005 International Society of Urological Pathology Consensus Conference. The consensus conference and subsequent articles proposing further modifications have helped pathologists to adapt the Gleason grading system to current urologic practice in a uniform manner. The changing definitions of Gleason pattern 3 and 4 prostatic adenocarcinoma have tended to narrow the scope of pattern 3 carcinoma and widen the scope of pattern 4 carcinoma. These modifications have had an important role in improving the inter-observer reproducibility of the Gleason system. Whether these changes have a significant impact on the clinical treatment of prostate cancer remains to be seen. However, as many of these modifications are supported only by a few studies, long-term follow-up studies with clinical end points are essential to validate these recommendations.
机译：引人注目的是，格里森分级系统启用40多年来，它仍然是前列腺癌中最有力的预后指标之一。然而，格里森最初的分级系统多年来经历了重大修改，首先是格里森及其同事，最近一次是在2005年国际泌尿外科病理学共识会议上。共识会议和随后提出的进一步修改的文章已帮助病理学家以统一的方式使格里森分级系统适应当前的泌尿科实践。格里森3型和4型前列腺癌的定义不断变化，倾向于缩小3型癌的范围，扩大4型癌的范围。这些修改在改善格里森系统的观察者间可重复性方面具有重要作用。这些变化是否对前列腺癌的临床治疗有重要影响尚待观察。但是，由于许多修饰仅受少数研究支持，因此具有临床终点的长期随访研究对于验证这些建议至关重要。

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