The Gleason scoring system is widely used for the grading and prognostication of prostate cancer. A Gleason pattern 4 subtype known as cribriform morphology has now been recognized as an aggressive and often lethal pattern of prostate cancer. The vast majority of published and ongoing prostate cancer studies still do not acknowledge the prognostic differences between various Gleason pattern 4 morphologies. As a result, current treatment recommendations are likely to be imprecise and not tailored towards patients who are most likely to die from the disease. Use of active surveillance for patients with Gleason score 3 + 4 prostate cancer has been suggested. However, the success of such paradigms would require cribriform morphology to be reported at the time of prostate biopsy, as patients harbouring such a pattern are poor candidates for surveillance. To date, only a limited number of studies have described the molecular alterations that occur in the cribriform morphological pattern. Further refinement of prostate cancer grading paradigms to distinguish cribriform from noncribriform Gleason pattern 4 is essential.

格里森评分系统广泛用于前列腺癌的分级和预后。格里森（Gleason）模式4亚型被称为筛状形态，现已被认为是前列腺癌的一种侵略性且通常是致死性的模式。绝大多数已发表和正在进行的前列腺癌研究仍未认识到各种Gleason模式4形态之间的预后差异。结果，当前的治疗建议可能是不准确的，而不是针对最有可能死于该疾病的患者的。已建议对格里森评分为3 + 4的前列腺癌患者采用主动监测。但是，这种范例的成功需要在前列腺穿刺活检时报告筛状形态，因为具有这种模式的患者不适合进行监视。迄今为止，只有有限的研究描述了筛状形态模式中发生的分子变化。进一步细化前列腺癌分级范例以区分筛状和非筛状格里森模式4是必不可少的。