Inter-observer variability of gleason grading in prostate cancer biopsies

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Abstract

Gleason score, which is an important histological parameter in determining therapeutic decisions for prostate cancer, has a high level of inter observer variability amongst general and specialist urological pathologists. A total of 96 prostate biopsies were reviewed and complete agreement was seen in seventy-two per cent of cases following central pathology review. Amongst cases which demonstrated Gleason score change, seventy-five per cent are downgraded whereas twenty-five per cent are upgraded. Most of the discrepancy involved pattern three and four, however, in our series, there was evidence of over interpretation of grade three and four and this might indicate the influence of modification of Gleason scoring which was adopted in 2005 of the international society of urological pathology (ISUP).

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