Browsing by Subject "Grading"

Now showing 1 - 4 of 4
  • Thumbnail Image
    Publication
    Open Access
    Bone remodelling and tumour grade modifications induced by interactions between bone and swarm rat chondrosarcoma
    (Murcia : F. Hernández, 2002) Grimaud, E.; Damiens, C.; Rousselle, A.V.; Passuti, N.; Heymann, D.; Gouin, F.
    Chondrosarcoma is currently defined as a malignant cartilage tumour arising de novo or within a pre-existing benign cartilage tumour. Chondrosarcoma can be surgically resected, but all grades have significant rates of local recurrence. The purpose of the present study was to develop an animal intraosseous chondrosarcoma model simulating the progression of human chondrosarcoma and elucidating its behaviour and biology. An intraosseous Swarm rat model was designed to assess interactions between bone and chondrosarcoma. A comparison of tumour grading was carried out according to transplantation site. The effects of chondrosarcoma cells (SRC cells) on the mineralisation capacities of osteoblasts and on osteoclast differentiation were studied in relation to modifications observed in vivo at the cellular level. Transplantation of Swarm rat chondrosarcoma within bone marrow or contiguous to induced periosteal lesions led to extensive bone remodelling with trabecular bone rarefaction and periosteal apposition. Transplantation in close contact to bone but without any periosteal lesion had no effect on bone, suggesting that bone healing factors interact with tumour development. With the intramedullary model, the development of tumours of different grade confirms that bone environment is an important factor in malignancy. A decrease of bone nodule formation was noted after cocultures of SRC cells with rat bone marrow, but there was no modification of osteoclast differentiation after cultures of total rabbit bone cells with SRC cells. These data reveal the importance of interactions between bone environment and tumour in inducing bone remodelling and variations in tumour malignancy.
  • Thumbnail Image
    Publication
    Open Access
    Grading lung neuroendocrine tumors: Controversies in search of a solution
    (Universidad de Murcia. Departamento de Biología Celular e Histología, 2017) Pelosi, Giuseppe; Pattini, Linda; Morana, Giovanni; Fabbri, Alessandra; Faccinetto, Alex; Fazio, Nicola; Valeri, Barbara; Sonzogni, Angelica
    Background. Pathological grading of tumors is a way to measure biological aggressiveness. In lung neuroendocrine tumors (NET), grading is tautologically included into the current 2015 WHO histologic classification. Little is known, however, about alternative grading systems in lung NET. Methods. Through an extensive search of the English literature on lung NET (updated to April 2016), the following key questions were addressed: a) current concepts of grading; b) clinicians’ requests for grading; c) functional parameters for grading; d) Ki-67 labeling index (LI) for grading; e) towards an effective pathology grading system. Results. There is some room for inconsistency in the histologic classification of lung NET, likely due to the varying attribution of defining criteria. Innovative diffusion-weighted imaging upon magnetic resonance or molecular analysis could help separate indolent from aggressive lung NET, thus integrating a grading approach other than histology. Troubles in the clinical handling of metastatic or individual tumors when relying on morphology alone support the development of a lungspecific grading system for the more accurate prediction of prognosis and planning therapy in individual patients. To integrate the 2015 WHO classification using innovative grading based on Ki-67 LI, mitotic count and necrosis, a new proposal is emerging where three categories of lung NET are identified, namely Lu-NET G1, Lu-NET G2 and Lu-NET G3, which would allow tumors with similar behavior and therapy to be better handled according to their own biological potential. Conclusion. A new formulation of lung NET grading could have clinical relevance for the individual handling of patients. Key words:
  • Thumbnail Image
    Publication
    Open Access
    Histological grading in colorectal cancer: new insights and perspectives
    (F. Hernández y Juan F. Madrid. Universidad de Murcia: Departamento de Biología Celular e Histología, 2015) Barresi, Valeria; Bonetti, Luca Reggiani; Leni, Antonio; Caruso, Rosario Alberto; Tuccari, Giovanni
    Poor histological differentiation is currently considered among the adverse histopathological factors associated with unfavourable clinical course of colorectal carcinoma (CRC). At present, the histological grade of CRC is assessed based on the percentage of glandular differentiation in the tumor according to the World Health Organization (WHO) criteria. However the prognostic value of the WHO grading system is limited by significant inter-observer variability in its assessment. In addition, the prognostic significance of WHO grading seems to depend on the microsatellite instability (MSI) status of the tumor. Finally, this grading does not apply to rarer histotypes of colorectal adenocarcinomas, such as the micropapillary, medullary, mucinous and signet ring cell variants. Recently a novel grading system based on the counting of clusters of five or more cells lacking a glandular structure (poorly differentiated clusters) and set in the tumor stroma or at invasive edge has been proposed in CRC. There is evidence that grading based on poorly differentiated clusters (PDC) is more reproducible and has more robust prognostic significance compared to WHO grading in CRC. In the present review we discuss the morphological features, criteria for the assessment, prognostic significance and correlation with biomolecular profiles of grading based on PDC counting in CRC.
  • Thumbnail Image
    Item
    Open Access
    Intraductal carcinoma of the prostate: A comprehensive literature review focused on grading challenges and controversies
    (2025) Vasiliki Tzelepi; Angeliki Pomoni; Ioanna Maria Grypari; Departamento de Biologia Celular e Histiologia; Universidad de Murcia, Departamento de Biologia Celular e Histiologia
    Intraductal carcinoma of the prostate (IDC-P) is characterized by neoplastic cell proliferation within pre-existing ducts or acini, exhibiting architectural and cytological atypia exceeding that of high-grade prostatic intraepithelial neoplasia. Its presence in needle biopsies and prostatectomies is associated with adverse clinical and pathological features, including large tumor volume, high grade, advanced stage, early biochemical recurrence, and intrinsic resistance to systemic therapy. Although rare, IDC-P can occasionally occur without concurrent invasive cancer or be associated with low-grade prostate cancer. Molecularly, IDC-P resembles its associated invasive carcinoma, sharing alterations typical of high-grade aggressive tumors. These findings support the hypothesis that IDC-P arises from the retrograde spread of invasive carcinoma, with ducts providing a protective niche against the tumor microenvironment. In contrast, isolated IDC-P and IDC-P associated with low-grade invasive carcinoma may represent precursor lesions. IDC-P must be distinguished from other intraductal lesions, both benign and malignant, particularly in needle biopsies, as its detection impacts therapeutic decisions. While grading does not apply to isolated IDC-P, there is an ongoing debate regarding IDC-P with synchronous invasive cancer. The International Society of Urological Pathology (2019) recommends incorporating IDC-P into Gleason score calculations, whereas the Genitourinary Pathology Society advises against grading it at all. Both approaches have merit, but further validation studies focusing on cases where IDC-P inclusion alters the final grade, though uncommon, are warranted