{"id":12771,"date":"2025-07-24T10:37:52","date_gmt":"2025-07-24T14:37:52","guid":{"rendered":"https:\/\/www.rigicon.com\/glossary-term\/gleason-score\/"},"modified":"2026-10-06T12:50:55","modified_gmt":"2026-10-06T16:50:55","slug":"escore-de-gleason","status":"publish","type":"glossary-term","link":"https:\/\/www.rigicon.com\/pt-br\/glossary-term\/escore-de-gleason\/","title":{"rendered":"Escore de Gleason"},"content":{"rendered":"","protected":false},"excerpt":{"rendered":"","protected":false},"featured_media":0,"template":"","glossary-category":[136],"glossary-product":[],"class_list":["post-12771","glossary-term","type-glossary-term","status-publish","hentry","glossary-category-prostate-cancer-diagnostics"],"acf":{"gt-definition":"<p>O escore de Gleason \u00e9 um sistema de gradua\u00e7\u00e3o utilizado para determinar a agressividade do c\u00e2ncer de pr\u00f3stata com base em qu\u00e3o anormais as c\u00e9lulas cancerosas de uma amostra de bi\u00f3psia parecem ao microsc\u00f3pio e em qu\u00e3o rapidamente tendem a crescer e se disseminar.<sup>1<\/sup> \u00c9 calculado somando-se os dois graus de c\u00e9lulas cancerosas que comp\u00f5em as maiores \u00e1reas da amostra de tecido biopsiado.<sup>2<\/sup> O grau de Gleason baseia-se principalmente na arquitetura ou disposi\u00e7\u00e3o das c\u00e9lulas malignas dentro do tumor, bem como em outros fatores, como o grau de diferencia\u00e7\u00e3o.<sup>3<\/sup><\/p>\n    \n    <p>Nesse sistema, os patologistas atribuem \u00e0s c\u00e9lulas cancerosas um grau de 1 a 5, com base no quanto elas se assemelham ao tecido prost\u00e1tico normal:<\/p>\n    <ul>\n        <li>Grau 1 significa que as c\u00e9lulas parecem quase iguais \u00e0s c\u00e9lulas prost\u00e1ticas normais<\/li>\n        <li>Grau 5 significa que as c\u00e9lulas parecem muito diferentes das c\u00e9lulas prost\u00e1ticas normais<sup>4<\/sup><\/li>\n    <\/ul>\n    \n    <p>Como os c\u00e2nceres de pr\u00f3stata frequentemente apresentam \u00e1reas com graus diferentes, o escore de Gleason \u00e9 determinado pela soma dos dois graus mais comuns encontrados na amostra. Por exemplo, se o padr\u00e3o mais comum for o grau 3 e o segundo mais comum for o grau 4, o escore de Gleason seria escrito como 3+4=7.<sup>5<\/sup> Se houver apenas um padr\u00e3o, esse grau \u00e9 duplicado.<\/p>\n    \n    <p>O escore de Gleason normalmente varia de 6 a 10, sendo que escores mais altos indicam um c\u00e2ncer mais agressivo, com maior probabilidade de crescer e se disseminar rapidamente.<sup>2<\/sup> Escores de 6 ou menos s\u00e3o considerados de baixo grau (bem diferenciados), 7 \u00e9 de grau intermedi\u00e1rio (moderadamente diferenciado) e 8-10 s\u00e3o de alto grau (pouco diferenciados).<sup>6<\/sup><\/p>\n    \n    <p>Em 2014, a confer\u00eancia de consenso da International Society of Urological Pathology recomendou um novo sistema de Grupos de Grau com cinco n\u00edveis, baseado no escore de Gleason:<\/p>\n    <ul>\n        <li>Grupo de Grau 1: escore de Gleason 6 ou menos (c\u00e2ncer de baixo grau)<\/li>\n        <li>Grupo de Grau 2: escore de Gleason 3+4=7 (c\u00e2ncer de grau m\u00e9dio)<\/li>\n        <li>Grupo de Grau 3: escore de Gleason 4+3=7 (c\u00e2ncer de grau m\u00e9dio)<\/li>\n        <li>Grupo de Grau 4: escore de Gleason 8 (c\u00e2ncer de alto grau)<\/li>\n        <li>Grupo de Grau 5: escore de Gleason 9-10 (c\u00e2ncer de alto grau)<sup>3,7<\/sup><\/li>\n    <\/ul>\n    \n    <p>Esse sistema foi desenvolvido para refletir melhor o comportamento biol\u00f3gico do c\u00e2ncer de pr\u00f3stata e para resolver a poss\u00edvel confus\u00e3o causada pelo fato de o menor escore comumente atribu\u00eddo ser 6 em uma escala te\u00f3rica de 2-10.<sup>8<\/sup><\/p>","gt-synonyms":"Grau de Gleason, soma de Gleason, sistema de classifica\u00e7\u00e3o de Gleason, padr\u00e3o de Gleason, sistema de grupo de notas ISUP, grau de c\u00e2ncer de pr\u00f3stata","gt-citation":"[1] Munjal A, Leslie SW. Gleason Score. StatPearls. 2023 May 1. DOI: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK553178\/\n\n[2] National Cancer Institute. Definition of Gleason score - NCI Dictionary of Cancer Terms. DOI: https:\/\/www.cancer.gov\/publications\/dictionaries\/cancer-terms\/def\/gleason-score\n\n[3] Epstein JI, Egevad L, Amin MB, et al. The 2014 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason Grading of Prostatic Carcinoma: Definition of Grading Patterns and Proposal for a New Grading System. Am J Surg Pathol. 2016;40(2):244-252. DOI: 10.1097\/PAS.0000000000000530\n\n[4] Mount Sinai. Gleason grading system Information. DOI: https:\/\/www.mountsinai.org\/health-library\/special-topic\/gleason-grading-system\n\n[5] American Cancer Society. Understanding Your Pathology Report: Prostate Cancer. 2023 Jul 7. DOI: https:\/\/www.cancer.org\/cancer\/diagnosis-staging\/tests\/biopsy-and-cytology-tests\/understanding-your-pathology-report\/prostate-pathology\/prostate-cancer-pathology.html\n\n[6] Pierorazio PM, Walsh PC, Partin AW, Epstein JI. Prognostic Gleason grade grouping: data based on the modified Gleason scoring system. BJU Int. 2013;111(5):753-760. DOI: 10.1111\/j.1464-410X.2012.11611.x\n\n[7] Epstein JI, Zelefsky MJ, Sjoberg DD, et al. A Contemporary Prostate Cancer Grading System: A Validated Alternative to the Gleason Score. Eur Urol. 2016;69(3):428-435. DOI: 10.1016\/j.eururo.2015.06.046\n\n[8] Gordetsky J, Epstein J. Grading of prostatic adenocarcinoma: current state and prognostic implications. Diagn Pathol. 2016;11:25. DOI: 10.1186\/s13000-016-0478-2","gt-clinical-context":"<p>O escore de Gleason \u00e9 um componente fundamental no manejo cl\u00ednico do c\u00e2ncer de pr\u00f3stata, utilizado para ajudar a determinar o progn\u00f3stico e orientar as decis\u00f5es terap\u00eauticas.<sup>1<\/sup> Normalmente \u00e9 utilizado em conjunto com outros par\u00e2metros cl\u00ednicos, como os n\u00edveis de ant\u00edgeno prost\u00e1tico espec\u00edfico (PSA) e o estadiamento cl\u00ednico, para estratificar o risco dos pacientes e elaborar planos de tratamento adequados.<sup>2<\/sup><\/p>\n    \n    <p>O sistema de pontua\u00e7\u00e3o \u00e9 aplicado ap\u00f3s a realiza\u00e7\u00e3o de uma bi\u00f3psia de pr\u00f3stata, geralmente motivada por n\u00edvel elevado de PSA, toque retal alterado ou outras indica\u00e7\u00f5es cl\u00ednicas.<sup>3<\/sup> Durante o procedimento de bi\u00f3psia, v\u00e1rias amostras de fragmentos s\u00e3o coletadas de diferentes \u00e1reas da gl\u00e2ndula prost\u00e1tica e examinadas por um patologista, que atribui os graus de Gleason.<sup>4<\/sup><\/p>\n    \n    <p>Significado cl\u00ednico dos diferentes escores de Gleason:<\/p>\n    <ul>\n        <li><strong>Escore de Gleason 6 (Grupo de Grau 1)<\/strong>: geralmente indica c\u00e2ncer de baixo risco com progn\u00f3stico favor\u00e1vel. Pacientes com esse escore podem ser candidatos \u00e0 vigil\u00e2ncia ativa em vez de interven\u00e7\u00e3o imediata, dependendo de outros fatores cl\u00ednicos.<sup>5<\/sup><\/li>\n        <li><strong>Escore de Gleason 7<\/strong>: c\u00e2ncer de risco intermedi\u00e1rio, sendo que 3+4=7 (Grupo de Grau 2) tem melhor progn\u00f3stico do que 4+3=7 (Grupo de Grau 3). A distin\u00e7\u00e3o \u00e9 importante, pois pode influenciar as decis\u00f5es terap\u00eauticas entre a vigil\u00e2ncia ativa e terapias mais definitivas, como cirurgia ou radioterapia.<sup>6<\/sup><\/li>\n        <li><strong>Escores de Gleason 8-10 (Grupos de Grau 4-5)<\/strong>: c\u00e2nceres de alto risco que normalmente exigem abordagens terap\u00eauticas mais agressivas. Esses c\u00e2nceres t\u00eam maior probabilidade de extens\u00e3o extraprost\u00e1tica, met\u00e1stase e mortalidade espec\u00edfica por c\u00e2ncer.<sup>7<\/sup><\/li>\n    <\/ul>\n    \n    <p>Diversos nomogramas progn\u00f3sticos incorporam o escore de Gleason juntamente com o n\u00edvel de PSA e o estadiamento cl\u00ednico para auxiliar no aconselhamento do paciente, classificando melhor a agressividade do risco. Entre eles est\u00e3o as tabelas de Partin da Johns Hopkins University, os nomogramas do Memorial Sloan Kettering Cancer Center (MSKCC) e o escore Cancer of the Prostate Risk Assessment (CAPRA) da University of California at San Francisco.<sup>8<\/sup><\/p>\n    \n    <p>O escore de Gleason demonstrou ter valor progn\u00f3stico significativo, com escores mais altos correlacionando-se a piores desfechos, incluindo maior risco de recidiva bioqu\u00edmica ap\u00f3s o tratamento, met\u00e1stase e mortalidade espec\u00edfica por c\u00e2ncer de pr\u00f3stata.<sup>9<\/sup> No entanto, \u00e9 importante observar que pode haver variabilidade interobservador na gradua\u00e7\u00e3o de Gleason, mesmo entre patologistas experientes, o que motivou esfor\u00e7os para padronizar o processo de gradua\u00e7\u00e3o por meio de programas de an\u00e1lise computadorizada e t\u00e9cnicas de intelig\u00eancia artificial.<sup>10<\/sup><\/p>","gt-related-evidence":null,"gt-featured":true,"gt-ai-referenced":false,"gt-view-count":100},"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.7 (Yoast SEO v28.7) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Escore de Gleason: Gradua\u00e7\u00e3o do C\u00e2ncer de Pr\u00f3stata | Rigicon<\/title>\n<meta name=\"description\" content=\"Entenda o escore de Gleason e grupos de grau ISUP para classifica\u00e7\u00e3o do c\u00e2ncer de pr\u00f3stata. 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