Is it a Gleason 3+4 or 4+3?

If you just do the math, the sum is the same – 7. But there is a significant difference between a prostate cancer determined by a pathologist to be Gleason 3 + 4, which has more lower-grade cells in it, and one that is labeled Gleason grade 4 + 3. Prostate cancer cells are graded on a formula system developed years ago by a pathologist named Gleason. He identified and numbered patterns of prostate cancer in grades of aggressiveness by determining which types of cells appear most commonly in a biopsy sample (and later, in the removed prostate specimen). Cancer given the highest Gleason grade – 8, 9, and 10 – is the most aggressive and in need of treatment. Gleason 7 cancer is different, depending on whether there are more cells labeled 3 or 4. 

"The difference between these two patterns can be the need to treat," says Robert Veltri, Ph.D., Director of the Fisher Family Laboratory. One problem is that this determination is often made in a subjective way, depending on which glandular tissue architecture and cell type that appears most often in biopsy samples, and later, in the removed prostate specimen. 

In recent work, Veltri and colleagues investigated 
two new computer-assisted imaging applications 
to see whether they can be more accurate than the human eye 
in determining the potential danger of prostate cancer cells.

In recent work, Veltri and colleagues investigated two new computer-assisted imaging applications to see whether they can be more accurate than the human eye in determining the potential danger of prostate cancer cells. These highly sophisticated programs looked at architectural features like the shape of the cells' nucleus, and tissue gland texture to identify Gleason grades 3 and 4. The results were promising. "In our future research, we hope we will be able to use these approaches to predict outcomes such as biochemical recurrence and progression to metastasis," says Veltri. 

In other news, Veltri was recognized as the Journal of Urology's "Outstanding Reviewer for Basic Science."

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