Gleason grading was performed according to the ISUP modified
Gleason grading was performed according to the 2005 ISUP modified Gleason grading system (Table 1, Fig. 1) (Epstein et al., 2005). The architectural patterns observed in our samples according to the modified Gleason grading system are illustrated in Fig. 2 and Fig. 3 and 4. Gleason score was obtained by adding the primary and secondary grades together. A tertiary pattern higher than the primary and secondary grades has been included in the final Gleason score as the secondary grade. This means that L-685,458 if a biopsy contained multiple patterns with 3, 4 and 5 in various proportions and pattern 5 being the least prevalent (tertiary grade), then the Gleason pattern 5 component was upgraded to a secondary grade before assigning the final Gleason score. The component of intraductal spread (cribriform or papillary) was counted as Gleason pattern 5 if covalent bond contained intraluminal comedonecrosis. Any amount of Gleason pattern 5 (even < 5% of PC), as long as recognisable at low-power examination, was considered significant and included for analysis.