title: Gleason grading of prostate cancer in needle core biopsies: a comparison of general and urologic pathologists.
abstract: OBJECTIVE
  The Gleason grading of prostate carcinoma (PCa) in needle core biopsies is a major determinant used in management planning. The objective of this study was to evaluate the concordance between general pathologists Gleason grading and that of a urologic pathologist in our community.
  
  
  METHODS
  Retrospective review conducted at three tertiary care hospitals in Jeddah and Riyadh for all prostatic biopsies with carcinoma from January 2002 to January 2011.
  
  
  METHODS
  Gleason scores assigned by the original pathologist were compared with that of the reviewing urologic pathologists. Biopsies were originally obtained and diagnosed at different referring hospitals and independent laboratories. The kappa test was used to evaluate agreement between the original and review scores.
  
  
  RESULTS
  For 212 biopsies the exact concordance of the Gleason score assigned by the original pathologist and the reviewer was 38.7% (82/212). However, when grouped into the main four-score categories of 2-4, 5-6, 7, and 8 or greater, disagreement was noted in 88 (41.5%) biopsies; 87 were upgraded and 1 was downgraded on review. When grouped into two-score categories of low grade (≤6) and high grade (≥7), disagreement was noted in 32 (15%) of the biopsies.
  
  
  CONCLUSIONS
  Gleason grade score shows that there was only slight to fair agreement between outside and review scoring (kappa=0.43). When using only low versus high grade categorization, there was good agreement (kappa=0.69). Almost all of the cases with score disagreement were upgraded on review.
authors: Department of Pathology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia. jalmaghrabi@hotmail.com
authors: Jaudah Ahmed
authors: JA
authors: Al-Maghrabi
authors: Nasir A
authors: NA
authors: Bakshi
authors: Hasan M A
authors: HM
authors: Farsi
mesh_terms: D001707:Biopsy, Needle; D002277:Carcinoma / Q000473:pathology*; D006801:Humans; D008297:Male; D060787:Neoplasm Grading / Q000706:statistics & numerical data*; D015588:Observer Variation; D010336:Pathology; D011467:Prostate / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000473:pathology*; D012189:Retrospective Studies; D014572:Urology