Prognostic significance of Gleason score 7 (3+4) and Gleason score 7 (4+3) in prostatic adenocarcinoma in relation to clinical stage, androgen tissue status and degree of neuroendocrine differentiation

Abstract

Prognosis and choice of treatment of adenocarcinoma of the prostate (ADCP) directly depend on the numerous of predictive factors, among which the most important are summary histological tumor grade (Gleason score, which is the sum of the first and second dominant histological grade) and clinical stage. According to recent research these factors include androgen tissue status and degree of neuroendocrine differentiation. The importance of the first and second dominant histological grade becomes particularly important in ADCP Gleason score 7. Tumors with worse prognosis considered to be ADCP of higher Gleason score, the advanced clinical stage, androgen independent tumors and tumors that show a higher degree of neuroendocrine differentiation. The aim of the study was to determine the predictive significance of ADCP Gleason score 7 (3+4) and ADCP Gleason score 7 (4+3) in relation to clinical stage, androgen tissue status and degree of focal neuroendocrine differentiation. The study included 33 ADCP of Gleason score 7,26 (78.79%) ADCP 7 (3+4) and 7 (21.21%) ADCP 7 (4+3). All tumors are most often diagnosed with stage D2, when there are already distant metastases. ADCP of Gleason score 7 (4+3) were diagnosed more often at this stage, among them there are more androgen independent tumors and they show a greater degree of focal neuroendocrine differentiation. All the results are in accordance with data from the literature suggesting that ADCP of Gleason score 7 (4+3) have a worse prognosis than ADCP of Gleason score 7 (3 +4).

Keywords

• prostate adenocarcinoma
• Gleason score
• clinical stage
• focal neuroendocrine differentiation
• androgen status