For patients suspected of having prostate cancer, neither ultrasound nor MRI, nor even PSA testing, can definitively diagnose prostate cancer. Currently, the gold standard for diagnosing prostate cancer is the pathology report from a tissue puncture biopsy. The pathology report usually states the type of prostate cancer tissue, such as prostate alveolar adenocarcinoma; and the Gleason score, a histological grading method for prostate cancer that is closely related to biological behavior and prognosis. There are two evaluation indicators with a total score of 10. A score of 2, 3, or 4 corresponds to highly differentiated adenocarcinoma (low risk); a score of 5, 6, or 7 corresponds to moderately differentiated adenocarcinoma (intermediate risk); and a score of 8, 9, or 10 corresponds to low/undifferentiated cancer (high risk). It has also been classified into three levels of <7 points, =7 points, >7 points. From this perspective, a prostate cancer puncture biopsy score of 5 is considered low to intermediate risk.
But because it is a puncture specimen, there is some margin of error and chance, so clinical evaluation of a prostate cancer’s criticality, treatment options, and prognosis still requires a combination of the patient’s general condition, Gleason score, PSA level, and tumor stage.