Degree of differentiation in colorectal adenocarcinomas: a multivariate analysis of the influence on survival.

Abstract

Patients who died from postoperative complica-. tions (30 cases) were excluded from the study, as were two cases in which histological grading could not be performed, and nine patients above 85 years of age at admission.The mean ages of the remaining 368 patients were 65-9 (SEM 0 7) for the men and 63 2 (0-4) years for the women (range 27 to 85 years).The histological sections were stained with haematoxylin and eosin and saffron. About three sections from each tumour were examined. The deepest infiltrating part of the tumour was represented in at least one of the sections in every case, and in most cases the transitional zone between normal mucosa and the tumour edge was also studied. The rectangular mounted sections measured between about I x 1 cm to 15 x 3-0cm.Histological grading was based on the degree of differentiation defined by the World Health Organisation's expert group on histological typing of intestinal tumours:5 well differentiated (low grade malignancy); moderately differentiated (average grade malignancy); and poorly differentiated (high grade malignancy) (fig 1). The presence and extent of areas exhibiting each of these differentiations was scored semiquantitatively for all sections taken from the primary tumour as follows: 0 = absent; I = present only in small areas; 2 = two or more degrees of differentiation distributed equally throughout the tissue; 3 = predominance of one type in most areas.A set of three scores was obtained for the degrees of differentiation in each tumour, and the tumours were 532 on 9 May 2018 by guest. Protected by copyright.

Cancer stem cells from colorectal cancer-derived cell lines

“…These results suggest that HCT116 contains a high proportion of CSCs that have lost the capacity to differentiate. This finding is exactly what might be expected for an aggressive and poorly differentiated tumor and correlates clinically with lymph node metastases (18,19) and reduced survival (20,21). HT29, on the other hand, is in general similar to SW1222, with a detectable proportion of stem cells with the capacity to differentiate.…”

Should the grading of colorectal adenocarcinoma include microsatellite instability status?

“…In this study, the proportion of MSI in high-grade adenocarcinomas was 20%, which is low compared with other studies that report up to 50% of MSI in high-grade tumors [19]. This difference may be due to the lack of standardization to define an adenocarcinoma as histologically high-grade [3,4,8,20]. While the WHO clearly sets the cutoff for gland formation to 50% to separate low-grade from highgrade adenocarcinomas, it is further specified that grading is based upon the least differentiated component, with the invading edge of tumor regarded as suboptimal to evaluate tumor grade [3].…”

“…Adenocarcinomas are graded into well-, moderately or poorly differentiated tumors (grades 1, 2, 3, respectively) depending on the proportion of gland formation in the least differentiated component of the tumor away from the invasive edge, according to the World Health Organization (WHO) criteria [3]. Despite low levels of agreement among pathologists on this subjective assessment [4,5], histologic grading has been shown to be an independent prognostic factor for colorectal carcinoma [6][7][8][9]. This is particularly true for the poorly differentiated subgroup that has been most consistently found to be associated with adverse clinical outcome.…”

Morphoregulatory activities of E-cadherin and beta-1 integrins in colorectal tumour cells

“…Thus colorectal carcinomas can be divided in three histological groups of low grade, average grade and high grade according to the degree of tubular differentiation. This classification reflects the behaviour of the tumour and significantly correlates with survival rate (Halvorsen & Seim, 1988). The molecular basis of glandular differentiation is therefore fundamental to our understanding of neoplastic cell behaviour.…”