Architectural (FIGO) grading, nuclear grading, and other prognostic indicators in stage I endometrial adenocarcinoma with identification of high-risk and low-risk groups

Abstract

We studied 164 cases of Stage I endometrial adenocarcinoma to determine the relative prognostic value of International Federation of Gynecology and Obstetrics (FIGO) and nuclear grading systems. Other factors known to be of prognostic value in endometrial carcinoma also were evaluated. Both the FIGO and nuclear grading systems correlated with five-year mortality rate from cancer. Nuclear Grade 3 proved to be a superior predictor of fatal outcome (nine of 13 [69%] ) over FIGO Grade 3 (four of 13 [31%]). We advocate the combined use of FIGO and nuclear grading systems, along with other prognostic parameters, for the detection of most patients with fatal cancer.

Prognostic impact of morphometric nuclear grade of endometrial carcinoma

“…Zaino et al 17 reported that subjective architectural grade (three groups) was superior to subjective nuclear grade (two groups) in predicting patient survival. In contrast, larger studies by Nordström et al 20 and Mittal et al 16 reported that subjective nuclear grade (three levels) was a stronger prognosticator than subjective architectural grade. Subjective nuclear grade showed a slightly better reproducibility between two independent observers in one of the studies, 17 whereas others have found subjective architectural grade to be the most reproducible.…”

pRb2/p130 and VEGF expression in endometrial carcinoma in relation to angiogenesis and histopathologic tumor grade

“…Different studies have reported disadvantages of the FIGO grading system. [22][23][24] A novel method that can be utilized for grading is a binary architectural grading system that uses low magnification assessments in order to determine the amount of solid tumor growth, the pattern of invasion, and the presence of necrosis which subdivides endometrial carcinomas into low-(A) and high-grade (B) tumors. Documented studies depict this system as a better method for grading endometrial carcinomas.…”

Endometri̇um Adenokanseri̇: 50 Vakanin Hi̇stoloji̇k Ve Hi̇stoki̇myasal Değerlendi̇rmesi̇

“…Bütünlüğünü göremediğimiz bir örnekte solid ve glandüler yapıların oranını saptayamayacağımız-dan dolayı morfolojik özelliklere dayanan gradeleme sistemini bu materyallere uygulamak son derece yanlış olacaktır. Morfolojik özelliklere dayanan gradeleme sistemi (16,17,18) ile yapılan değerlendirmede küretaj materyaline verilen grade, histerektomi materyalinden en az bir grade düşük veya yüksek olabilecektir (24). Bizim çalışmamızda küretaj materyalinden grade alan 5 vakanın grade derecesinde bir derece artma saptanmıştır.Bu nedenle küretaj materyalinden değerlendirme yapılırken gradelemede histomorfolojik yapıdan çok, nükleer atipi göz önünde bulundurulmalıdır.…”

“…Histokimyasal yöntemlerin yardımıyla yeniden değerlendirmeye alınan vakalar Philips 1991 sınıfla-masına göre klasifiye edimiş ve tümörlerin gradelemesinde nükleer gradeleme ve FİGO gradelemesi birlikte kullanılmıştır (16,17,18) Bu her iki sisteme göre ; minimal nükleus atipisi ve yaygın tübüler yapılar içeren tümörler Grade 1 (şekil 1), orta derecede nükleus atipisi ve %50 solid alan içeren tümörler Grade 2 (şekil 2), belirgin nükleus atipisi ve %50 den fazla solid alan içeren tümörler Grade 3 olarak değerlendirilmiştir (şe-kil 3).…”