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Of the many cancer-specific schemes, the Gleason system, [3] named after Donald Floyd Gleason, used to grade the adenocarcinoma cells in prostate cancer is the most famous. This system uses a grading score ranging from 2 to 10. Lower Gleason scores describe well-differentiated less aggressive tumors.
For example, if the primary tumor grade was 2 and the secondary tumor grade was 3 but some cells were found to be grade 4, the Gleason score would be 2+4=6. This is a slight change from the pre-2005 Gleason system where the second number was the secondary grade (i.e., the grade of the second-most common cell line pattern). [4]
G (1–4): the grade of the cancer cells (i.e. they are "low grade" if they appear similar to normal cells, and "high grade" if they appear poorly differentiated) S (0–3): elevation of serum tumor markers; R (0–2): the completeness of the operation (resection-boundaries free of cancer cells or not) Pn (0–1): invasion into adjunct nerves
Grade 3: Clearly visible nucleoli at magnification of 100 times ... Only 2–4% of the cases presenting as part of an inherited cancer syndrome, ... Clear-cell renal ...
Stage 0: carcinoma in situ, abnormal cells growing in their normal place ("in situ" from Latin for "in its place"). Stage 0 can also mean no remaining cancer after preoperative treatment in some cancers (e.g. colorectal cancer). Stage I: cancers are localized to one part of the body. Stage I cancer can be surgically removed if small enough.
The scores for each of these three criteria are added together to give a final overall score and a corresponding grade as follows: 3-5 Grade 1 tumor (well-differentiated). Best prognosis. 6-7 Grade 2 tumor (moderately differentiated). Medium prognosis. 8-9 Grade 3 tumor (poorly differentiated). Worst prognosis.