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Stuttgart, Germany

Helpap B.,HBH Hospital | Kristiansen G.,University of Bonn | Beer M.,University of Zurich | Kollermann J.,Institute of Pathology | And 3 more authors.
Pathology and Oncology Research | Year: 2012

High upgrading rates of Gleason score 6 to 7 carcinomas between biopsy and radical prostatectomy specimens may be produced by change of fused glands of pattern 3 to pattern 4. Therefore, inter-observer reproducibility of fused and non-fused glands in biopsy specimens was analysed. Images of H&E stained slides of glands of carcinomas with Gleason score 6 and 7 (3+4) with and without glandular fusions with different lens magnification were analysed by 4 specialized genitourinary pathologists and 3 non-specialized pathologists. The definition of glandular fusion was a complete lack of any stromal fibres between a minimum of two glands and only one line of nuclei within the area of fusion. Overall agreement and interobserver reproducibility of fused versus non-fused glands of non- and uro-pathologically specialized pathologists were lower in lens magnification of 50× in contrast to 200×. The inter-observer reproducibility of fused glands by specialized observer was higher than that of nonspecialized pathologists. The results support the importance of strict but practicable criteria for the diagnosis of fused tumor glands in order to decrease the interobserver variability of Gleason scores, particularly in nonspecialised pathologists. © Arányi Lajos Foundation 2011. Source


Helpap B.,HBH Hospital | Ringli D.,HBH Hospital | Shaikhibrahim Z.,University of Bonn | Wernert N.,University of Bonn | Kristiansen G.,University of Bonn
Pathology Research and Practice | Year: 2013

Prostate carcinoma (PCa) with Gleason score (GS) 7 has to be examined differentially regarding its prognosis. Using the criteria of ISUP and supplementations, we attempted to analyze the heterogeneity of PCa with GS 7 of biopsy and corresponding specimens of radical prostatectomies (RP).PCa of 530 patients were graded according to Gleason under additional consideration of the state of the nucleoli. Investigating the biopsy specimens, we determined the pattern of Gleason 4 of GS 7, the extension of the tumors in percent, and the number of biopsies containing tumor. In the corresponding specimens of RP, the grading and the state of TNM with margins were assessed.Carcinomas with GS 7 (4. +. 3) in biopsy and RP specimens were unequivocally assigned to the group of high-grade tumors. Carcinomas with GS 7 (3. +. 4) were significantly different from carcinomas with GS 6 when only few and small nucleoli in GS 6 were present (low grade type, p≤0.0001), but were similar to the GS 6 group when nucleoli were prominent (intermediary type, p=0.71).The intermediary group showed an upgrading rate of 36% from GS 6 to GS 7. Furthermore the correlation between organ-confined and non-organ-confined growth showed differences of 63% and 37% in the intermediary group (p=0.0001).The values of grading, staging, margins and metastases indicate that carcinomas of the prostate with the Gleason 3. +. 4 pattern correspond to an intermediary group of carcinomas in contrast to high-grade (high risk) carcinomas with GS 7 and pattern 4 + 3. © 2013 Elsevier GmbH. Source

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