What is the Difference Between PSA and Gleason Score?

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The main difference between PSA and Gleason score lies in their purpose and the information they provide about prostate cancer. Here are the key differences:

  • PSA (Prostate-Specific Antigen): PSA is a protein produced by cells in the prostate gland and is found in circulation. It is measured in nanograms per milliliter of blood (ng/ml). Elevated PSA levels can be a marker of prostate cancer, but it is not specific to the disease and can be influenced by factors such as age, prostate size, and inflammation.
  • Gleason Score: The Gleason score is a grading system that assesses the aggressiveness of prostate cancer cells based on their histological appearance under a microscope. The pathologist assigns a score from 3 to 5 to the main pattern of cell growth and another area of growth, and then adds these scores together to obtain an overall score between 6 and 10. A lower Gleason score indicates less aggressive cancer, while a higher score signifies more aggressive cancer.

In summary, PSA is a blood test used to detect potential prostate cancer, while the Gleason score evaluates the aggressiveness of cancer cells in the prostate based on their histological appearance. Doctors use both PSA levels and Gleason scores, along with other factors such as cancer stage, to help plan treatment and determine the risk of advancing cancer.

Comparative Table: PSA vs Gleason Score

The main difference between PSA and Gleason scores lies in their purpose and measurement. Here is a table that compares the two:

Feature PSA (Prostate-Specific Antigen) Gleason Score
Purpose PSA is a protein marker that can indicate the presence of prostate cancer or other prostate-related conditions. It is measured in the blood and can be used to monitor the disease and the effectiveness of treatment. The Gleason score is a pathological assessment of the prostate cancer cells. It is determined based on a biopsy or surgical specimen and helps predict the aggressiveness of the cancer and guide treatment decisions.
Measurement PSA level is measured in nanograms per milliliter (ng/mL) of blood. Gleason score is determined by examining the cancer cells under a microscope and assigning them a grade of 3 to 5. The two most common grades are added together to get a Gleason score.
Range PSA levels can range from 0 to over 100 ng/mL. The higher the level, the more likely it is that a person has prostate cancer or another prostate-related condition. Gleason scores range from 6 (lowest aggressiveness) to 10 (highest aggressiveness). The score is based on the two most common grades found in the prostate cancer sample. For example, a score of 3 + 4 = 7 indicates that the cancer cells have a mix of grade 3 and grade 4 features.
Importance Elevated PSA levels can signal the presence of prostate cancer or other prostate-related conditions, such as benign prostatic hyperplasia (BPH) or prostatitis. PSA levels can also be used to monitor the effectiveness of treatment and detect recurrence of prostate cancer. The Gleason score helps doctors predict how likely the cancer is to grow and spread. It is an important factor in determining the stage of prostate cancer and guiding treatment decisions.

In summary, PSA is a blood test used for screening, diagnosis, and monitoring prostate cancer, while the Gleason score is a pathological assessment of the cancer cells that helps predict the aggressiveness of the cancer and guide treatment decisions.