
Prostate cancer prognosis relies heavily on the Gleason Classification System, yet subjective interpretation underscores the need for supplementary markers. The study explores reactive stroma (RS) as a potential prognostic factor by examining its association with acinar morphology and collagen deposition. Analyzing 120 prostate biopsies, two pathologists identified prominent RS in high Gleason score tumors (≥4 + 3), particularly in stromogenic tumors. Acinar patterns B and D displayed strong correlations with RS and high collagen fiber density, as confirmed by advanced imaging techniques. Additionally, rudimentary microacini with intense RS in these patterns may indicate a poorer prognosis. The findings support RS as a complementary factor in prostate cancer prognosis, suggesting further investigation into its role could improve prognostic accuracy and guide therapeutic approaches.
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