# Gleason score (1974)

Gleason score

Status: LIVE
Price: $0.005 USDC
`GET /api/calc/gleason`
HTML: https://magentlab.com/docs/gleason
Markdown: https://magentlab.com/docs/gleason.md

Not a medical device. Not a diagnosis, dose, or listing recommendation.

## What it computes

Sum caller-assigned Gleason 1974 primary and secondary histologic patterns (each 1-5) and return score 2-10. magent does not read slides. Not ISUP/Epstein 2016 Grade Groups.

## When to use

When an agent already has caller-assigned Gleason 1974 primary and secondary patterns and needs the published 2-10 sum. magent does not read slides, assign pattern from histology, emit ISUP/Epstein 2016 Grade Groups, or apply 2005 ISUP modified pattern rules.

## When not to use

- Not a medical device. magent does not read slides.
- The caller assigns Gleason 1974 primary and secondary patterns 1-5. magent does not grade glands or inspect architecture.
- Gleason 1974 primary-plus-secondary sum only (range 2-10). Not ISUP/Epstein 2016 Grade Groups (1-5). Not 2005 ISUP modified pattern rules.
- Gleason 1974 does not name poorly/moderately/well-differentiated score bands on this tool. This tool does not emit those labels.
- Not a diagnosis of prostatic adenocarcinoma. Not a treatment or prostatectomy recommendation.

## Formula

```
Gleason score = primary + secondary; each pattern 1-5 as assigned by the caller (Gleason 1974); range 2-10. magent does not read slides. Not ISUP/Epstein 2016 Grade Groups. Not 2005 ISUP modified pattern rules.
```

## Citation

[Prediction of prognosis for prostatic adenocarcinoma by combined histological grading and clinical staging](https://doi.org/10.1016/S0022-5347(17)59889-4)
Gleason DF, Mellinger GT, Veterans Administration Cooperative Urological Research Group
J Urol. 1974;111(1):58-64
DOI: [10.1016/S0022-5347(17)59889-4](https://doi.org/10.1016/S0022-5347(17)59889-4)

## Worked example

### Primary 3 secondary 3 is score 6

Given: `primary=3, secondary=3`

1. primary 3 as assigned by the caller
2. secondary 3 as assigned by the caller
3. score = 3 + 3 = 6 (max 10)


### Primary 5 secondary 5 is score 10

Given: `primary=5, secondary=5`

1. primary 5 as assigned by the caller
2. secondary 5 as assigned by the caller
3. score = 5 + 5 = 10 (max 10)


## Also searched as

- Gleason score
- Gleason 1974
- Gleason pattern
- prostatic adenocarcinoma Gleason
- Gleason primary secondary
- Gleason sum
- prostate Gleason score
- Gleason histologic grade

## Parameters

- `primary` (integer, required): Caller-assigned Gleason 1974 primary (predominant) histologic pattern. Integer 1-5 only; reject 0, 6, 1.5, and roman I. magent does not read slides or apply 2005 ISUP modified pattern rules.
- `secondary` (integer, required): Caller-assigned Gleason 1974 secondary histologic pattern. Integer 1-5 only; reject 0, 6, 1.5, and roman I. magent does not read slides or apply 2005 ISUP modified pattern rules.

## Bulk (POST)

POST the same path with a JSON items array. The first item is the GET unit; each additional item is $0.002. Invalid items return HTTP 400 before settlement.

Method: `POST /api/calc/gleason`
Max items: 25
Price: unit_amount + extra_item_amount * (n - 1) (unit 5000 atomic, extra 2000 atomic)
Status: PREVIEW

- 1 to 25 items. Each item uses the same keys as the GET query parameters.
- POST of 1 item costs the same as GET. Lists longer than 25: chunk into multiple POSTs. Extra items still execute; do not pad dummy rows.
- The first invalid item fails the whole request (index in the 400 JSON). You are not charged.
- HTTP 200 is {count, path, items}. Each items[i] is the GET 200 body for that row.
- Catalog misses (empty matches, found=false) stay paid 200s inside that slot.
- x402 resource URL is this path plus n and body_sha256. Browsers that prefer text/html get the same paywall as GET; Pay retries POST with the same items.

Example request:

```json
{
  "items": [
    {
      "primary": "3",
      "secondary": "3"
    },
    {
      "primary": "3",
      "secondary": "3"
    }
  ]
}
```

Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/gleason

Example 200:

```json
{
  "count": 2,
  "path": "/api/calc/gleason",
  "items": [
    {
      "primary": 3,
      "components": [
        {
          "value": 3,
          "factor": "primary",
          "points": 3,
          "present": true
        },
        {
          "value": 3,
          "factor": "secondary",
          "points": 3,
          "present": true
        }
      ],
      "secondary": 3,
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Gleason DF, Mellinger GT, Veterans Administration Cooperative Urological Research Group",
        "doi": "10.1016/S0022-5347(17)59889-4",
        "id": "gleason-1974",
        "pmid": "4813554",
        "source": "J Urol. 1974;111(1):58-64",
        "title": "Prediction of prognosis for prostatic adenocarcinoma by combined histological grading and clinical staging"
      },
      "formula": "gleason",
      "formula_expression": "Gleason score = primary + secondary; each pattern 1-5 as assigned by the caller (Gleason 1974); range 2-10. magent does not read slides. Not ISUP/Epstein 2016 Grade Groups. Not 2005 ISUP modified pattern rules.",
      "max_score": 10,
      "score": 6
    },
    {
      "primary": 3,
      "components": [
        {
          "value": 3,
          "factor": "primary",
          "points": 3,
          "present": true
        },
        {
          "value": 3,
          "factor": "secondary",
          "points": 3,
          "present": true
        }
      ],
      "secondary": 3,
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Gleason DF, Mellinger GT, Veterans Administration Cooperative Urological Research Group",
        "doi": "10.1016/S0022-5347(17)59889-4",
        "id": "gleason-1974",
        "pmid": "4813554",
        "source": "J Urol. 1974;111(1):58-64",
        "title": "Prediction of prognosis for prostatic adenocarcinoma by combined histological grading and clinical staging"
      },
      "formula": "gleason",
      "formula_expression": "Gleason score = primary + secondary; each pattern 1-5 as assigned by the caller (Gleason 1974); range 2-10. magent does not read slides. Not ISUP/Epstein 2016 Grade Groups. Not 2005 ISUP modified pattern rules.",
      "max_score": 10,
      "score": 6
    }
  ]
}
```

## Response fields

- `formula` (string): gleason
- `formula_expression` (string): Published Gleason 1974 primary-plus-secondary sum
- `primary` (integer): Caller-assigned Gleason 1974 primary pattern 1-5
- `secondary` (integer): Caller-assigned Gleason 1974 secondary pattern 1-5
- `score` (integer): primary + secondary (range 2-10)
- `max_score` (integer): 10
- `components` (array): Per-pattern Points rows primary and secondary; points equal the integer itself
- `citation` (object): Gleason 1974 J Urol citation
- `disclaimer` (string): Not-a-device notice

## Example JSON

Frozen fixture. Not a live lookup.

```json
{
  "primary": 3,
  "components": [
    {
      "value": 3,
      "factor": "primary",
      "points": 3,
      "present": true
    },
    {
      "value": 3,
      "factor": "secondary",
      "points": 3,
      "present": true
    }
  ],
  "secondary": 3,
  "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
  "citation": {
    "authors": "Gleason DF, Mellinger GT, Veterans Administration Cooperative Urological Research Group",
    "doi": "10.1016/S0022-5347(17)59889-4",
    "id": "gleason-1974",
    "pmid": "4813554",
    "source": "J Urol. 1974;111(1):58-64",
    "title": "Prediction of prognosis for prostatic adenocarcinoma by combined histological grading and clinical staging"
  },
  "formula": "gleason",
  "formula_expression": "Gleason score = primary + secondary; each pattern 1-5 as assigned by the caller (Gleason 1974); range 2-10. magent does not read slides. Not ISUP/Epstein 2016 Grade Groups. Not 2005 ISUP modified pattern rules.",
  "max_score": 10,
  "score": 6
}
```

## Errors

- HTTP 400 `invalid_gleason`: Gleason score inputs must be caller-assigned pattern integers 1-5 for the two patterns summed in Gleason 1974. Returned before settlement; you are not charged.
- HTTP 400 `invalid_items`: POST body must be a JSON object with only an items array Returned before settlement; you are not charged.
- HTTP 400 `invalid_item_count`: items must be an array of 1 to 25 objects Returned before settlement; you are not charged.
- HTTP 400 `invalid_item`: each items entry must be a JSON object Returned before settlement; you are not charged.

Shared HTTP 402 and 503: https://magentlab.com/docs/payments

## Related tools

- [Fuhrman](https://magentlab.com/docs/fuhrman) — Echo the caller-assigned Fuhrman 1982 nuclear grade (1-4) with the published nuclear-feature description. magent does not read slides. Not WHO/ISUP 2016.
- [UISS](https://magentlab.com/docs/uiss) — Apply the Zisman 2002 localized N0M0 three-group UISS algorithm to caller-assigned 1997 pathological T, Fuhrman grade, and ECOG PS and return low_risk, intermediate_risk, or high_risk. Does not compute a predicted 5-year disease-specific survival.

## Payment

Unpaid requests return HTTP 402 even if query parameters or POST items are missing or invalid, so CDP and agents can index the path. After a PAYMENT-SIGNATURE, invalid params return HTTP 400 JSON before settlement. magent does not charge. Fix the params, then request a new 402 quote for that complete URL. Catalog misses (empty matches, found=false) are valid paid 200s.

- GET the tool with Accept: application/json (do not send Accept: text/html unless you want the human paywall).
- HTTP 402 means you have not paid. Decode the base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote.
- Sign accepts[0] (exact, EIP-3009) with validBefore = now + maxTimeoutSeconds (600 seconds), or accepts[1] (batch-settlement deposit/voucher) on product GET. Ping and POST {items} stay exact. Magent retries transient facilitator 429/5xx before answering.
- Retry the same URL with PAYMENT-SIGNATURE (base64 JSON of accepted and payload). Magent attaches canonical extensions.bazaar on CDP verify/settle; echoing 402 bazaar is optional.
- Success is HTTP 200 JSON plus PAYMENT-RESPONSE. exact settles before the tool. batch-settlement verifies (and deposit-settles) before the tool and commits the charge after HTTP 2xx. HTTP 503: retry the same PAYMENT-SIGNATURE. Mint a new exact nonce only after a new HTTP 402.

- offered `exact` on eip155:8453: Fixed-price USDC on Base. The buyer authorizes the advertised amount (EIP-3009). magent settles before the tool runs (paymentFlow upfront). extra.assetTransferMethod=eip3009 extra.paymentFlow=upfront.
- offered `batch-settlement` on eip155:8453: Payment-channel vouchers claimed later in batches. Exact stays accepts[0]. Same-path POST {items} is still exact. extra.assetTransferMethod=eip3009 extra.paymentFlow=authorization.

- not offered `upto`: Not offered. Usage-based: buyer authorizes a ceiling, seller settles the actual amount after work. Reserved for a future metered tool. Not for current calculators or code search.

Same-path POST {items} is still scheme exact: one EIP-3009 authorization for GET unit plus $0.002 per extra item. That is not x402 batch-settlement (payment channels / vouchers).

Shared HTTP 402 and 503 table: https://magentlab.com/docs/payments

Stdio MCP (one process per host): https://magentlab.com/docs/mcp

## Guarantees

- HTTP 402 is unpaid, including a missing query. After PAYMENT-SIGNATURE, invalid parameters return HTTP 400 before settlement. You are not charged. HTTP 402 never includes the tool JSON.
- exact: settlement finishes before the tool (paymentFlow upfront). batch-settlement: verify/deposit before the tool; chargedCumulativeAmount commits after HTTP 2xx. Uncertain or failed settlement fails closed (HTTP 503). Retry the same PAYMENT-SIGNATURE.
- HTTP 402 is unpaid only. Do not sign a second authorization because of a 503.
- Execution is timeout-bounded and concurrency-capped.
- Calculator inputs are stored encrypted for allowlisted operators (Magent Console). They are not in public logs, SSH lookups, catalog, or rollups. Request logs store path without query.