Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
BMC Urology
Published in: BMC Urology 1/2015

Open Access 01-12-2015 | Research article

Review by urological pathologists improves the accuracy of Gleason grading by general pathologists

Authors: Yasushi Nakai, Nobumichi Tanaka, Keiji Shimada, Noboru Konishi, Makito Miyake, Satoshi Anai, Kiyohide Fujimoto

Published in: BMC Urology | Issue 1/2015

Login to get access

Abstract

Backgrounds

Urologists use biopsy Gleason scores for patient counseling, prognosis prediction, and decision making. The accuracy of Gleason grading is very important. However, the variability of Gleason grading between general pathologists cannot be overlooked. Here we evaluate the discrepancy in the Gleason grading between 2 urologic pathologists and general pathologists as well as improvement in the accuracy of Gleason grading by general pathologists as a result of review by urologic pathologists.

Methods

The subjects enrolled in the study were 755 patients who underwent prostate needle biopsy at affiliate hospitals of Nara Medical University over a period of 2 years. The biopsy samples were diagnosed by general pathologists. All biopsy samples were sent to Nara Medical University where they were diagnosed by 2 urologic pathologists. The results were then returned to the general pathologists. We compared the diagnostic accuracy of the general pathologists with that of the urologic pathologists for the parameters of no malignancy, atypical small acinar proliferation, high grade prostatic intraepithelial neoplasia and Gleason score (6, 3 + 4, 4 + 3 and 8–10). We then evaluated the concordance rate between the general and urologic pathologists for each of four consecutive 6-month periods.

Results

The overall concordance rate of urologic pathologists and general pathologists in the first, second, third and last 6-month periods was 71.8 % (140/198), 79.8 % (168/225), 89.7 % (166/185) and 89.9 % (133/148), respectively. The concordance rate of the Gleason score between urologic pathologists and general pathologists in the first, second, third and last 6-month periods was 47.5 %(38/80), 62.6 %(57/91),76.9 %(50/65) and 78.7 %(48/61), respectively, and the kappa value was 0.55, 0.68, 0.81 and 0.84, respectively. The concordance rate improved significantly over the course of each period (P = 0.04).

Conclusion

The concordance rate of the Gleason grading between the general pathologists and the urologic pathologists was 47.5 %. However, improvement of the concordance rate as a result of review by the urological pathologist could be seen.
Literature
1.
Gleason DF. Classification of prostatic carcinoma. Cancer Chemother Rep. 1966;50:125.PubMed
2.
Gleason DF, Mellinger GT. Prediction of prognosis for prostatic adenocarcinoma by combined histological grading and clinical staging. J Urol. 1974;111:58.PubMed
3.
Gleason DF. Histologic grading and clinical staging of prostatic carcinoma. In: Tannenbaum M, editor. Urologic Pathology: The Prostate. Philadelphia: Lea and Febiger; 1977. p. 171.
4.
Japanese Urological Association and the Japanese Society of Pathology, editor. General rule for clinical and pathological studies on prostate cancer. 3rd ed. Tokyo: Kanahara-Shuppan; 2001.
5.
Oesterling JE, Brendler CB, Epstein JI, Kimball AW Jr, Walsh PC. Correlation of clinical stage, serum prostatic acid phosphatase and preoperative Gleason grade with final pathological stage in 275 patients with clinically localized adenocarcinoma of the prostate. J Urol. 1987;38:92.
6.
Epstein JI, Pizov G, Walsh PC. Correlation of pathologic findings with progression after radical retropubic prostatectomy. Cancer. 1993;71:3582.CrossRefPubMed
7.
Partin AW, Mangold LA, Lamm DM, Walsh PC, Epstein JI, Pearson JD. Contemporary update of prostate cancer staging nomograms (Partin Tables) for the new millennium. Urology. 2001;58:843.
8.
Allsbrook WC Jr, Mangold KA, Johnson MH, Lane RB, Lane CG, Amin MB et al. Interobserver reproducibility of Gleason grading of prostatic carcinoma: urologic pathologists. Hum Pathol. 2001;32:74.
9.
McLean M, Srigley J, Banerjee D, Warde P, Hao Y. Interobserver variation in prostate cancer Gleason scoring: are there implications for the design of clinical trials and treatment strategies? Clin Oncol (R Coll Radiol). 1997;9:222.
10.
Coard KC, Freeman VL. Gleason grading of prostate cancer: level of concordance between pathologists at the University Hospital of the West Indies. Am J Clin Patol. 2004;122:373.CrossRef
11.
Epstein JI, Allsbrook WC Jr, Amin MB, Egevad LL.The 2005 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason Grading of Prostatic Carcinoma. Am J Surg Pathol. 2005;29:1228.
12.
Billis A, Quintal MM, Meirelles L, Freitas LL, Costa LB, Bonfitto JF, et al. The value of the 2005 International Society of Urological Pathology (ISUP) modified Gleason grading system as a predictor of biochemical recurrence after radical prostatectomy. Int Urol Nephrol. 2014;46:935.
13.
Dong F, Wang C, Farris AB, Wu S, Lee H, Olumi AF, et al.  Impact on the clinical outcome of prostate cancer by the 2005 international society of urological pathology modified Gleason grading system. Am J Surg Pathol. 2012;36:838.
14.
Ito K, Ohi M, Yamamoto T, Miyamoto S, Kurokawa K, Fukabori Y, et al.The diagnostic accuracy of the age-adjusted and prostate volume-adjusted biopsy method in males with proatate specific antigen levels of 4.1-10.0 ng/mL. Cancer. 2002;95:2112.
15.
Tanaka N1, Fujimoto K, Yoshikawa M, Tanaka M, Hirao Y, Kondo H, et al. Prostatic volume and volume-adjusted prostate-specific antigen as predictive parameters for T1c prostatecancer. Hinyokika kiyo. 2007;53:459.
16.
Han M, Partin AW, Zahurak M, Piantadosi S, Epstein JI, Walsh PC. Biochemical (prostate specific antigen) recurrence probability following radical prostatectomy for clinically localized prostate cancer. J Urol. 2003;169:517.
17.
Tanaka N, Fujimoto K, Hirayama A, Torimoto K, Okajima E, Tanaka M, et al. Risk-stratified survival rates and predictors of biochemical recurrence after radical prostatectomy in a Nara, Japan, cohort study. Int J Clin Oncol. 2011;16:553.
18.
Potters L, Purrazzella R, Brustein S, Fearn P, Huang D, Leibel SA, et al. The prognostic significance of Gleason grade in patients treated with permanent prostate brachytherapy. Int J Radiat Oncol Boil Phys. 2003;56:749.
19.
Sabolch A1, Feng FY, Daignault-Newton S, Halverson S, Blas K, Phelps L, et al. Gleason pattern 5 is the greatest risk factor for clinical failure and death from prostate cancer after dose-escalated radiation therapy and hormonal ablation. Int J Radiat Oncol Boil Phys. 2011;81:e351.
20.
Burchardt M, Engers R, Müller M, Burchardt T, Willers R, Epstein JI, et al. Interobserver reproducibility of Gleason grading: evaluation using prostate cancer tissue microarrays. J cancer Res Clin Oncol. 2008;134:1071.
21.
King CR, McNeal JE, Gill H, Presti JC Jr. Extended prostate biopsy scheme improves reliability of Gleason grading: implications for radiotherapy patients. Int J Radiat Oncol Biol Phys. 2004;59:386.
22.
Mikami Y, Manabe T, Epstein JI, Shiraishi T, Furusato M, Tsuzuki T, et al. Accuracy of Gleason grading by practicing pathologists and the impact of education on improving agreement. Hum Pathol. 2003;34:658.
23.
Egevad L. Reproducibility of Gleason grading of prostate cancer can be improved by the use of reference images. Urology. 2001;57:291.
24.
Barqawi AB, Turcanu R, Gamito EJ, Lucia SM, O'Donnell CI, Crawford ED, et al. The value of second-opinion pathology diagnosis on prostate biopsies from patients reffered for management of prostate cancer. Int J Clin Exp Pathol. 2011;4:468–75.
Metadata
Title
Review by urological pathologists improves the accuracy of Gleason grading by general pathologists
Authors
Yasushi Nakai
Nobumichi Tanaka
Keiji Shimada
Noboru Konishi
Makito Miyake
Satoshi Anai
Kiyohide Fujimoto
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Urology / Issue 1/2015
Electronic ISSN: 1471-2490
DOI
https://doi.org/10.1186/s12894-015-0066-x

Other articles of this Issue 1/2015

BMC Urology 1/2015 Go to the issue

Research article

Preclinical assessment of potential interactions between botulinum toxin and neuromodulation for bladder micturition reflex

Research article

Active surveillance of prostate cancer: a questionnaire survey of urologists, clinical oncologists and urology nurse specialists across three cancer networks in the United Kingdom

Research article

Protein kinase C modulates frequency of micturition and non-voiding contractions in the urinary bladder via neuronal and myogenic mechanisms

Research article

3D vs 2D laparoscopic radical prostatectomy in organ-confined prostate cancer: comparison of operative data and pentafecta rates: a single cohort study

Research article

Prevalence of human papillomavirus in penile malignant tumors: viral genotyping and clinical aspects

Research article

Feasibly of axitinib as first-line therapy for advanced or metastatic renal cell carcinoma: a single-institution experience in Japan