Publication: Histological grading in colorectal
cancer: new insights and perspectives
Authors
Barresi, Valeria ; Bonetti, Luca Reggiani ; Leni, Antonio ; Caruso, Rosario Alberto ; Tuccari, Giovanni
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Publisher
F. Hernández y Juan F. Madrid. Universidad de Murcia: Departamento de Biología Celular e Histología
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DOI
https://doi.org/10.14670/HH-11-633
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info:eu-repo/semantics/article
Description
Abstract
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.
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Citation
Histology and histopathology, Vol. 30, nº 9 (2015)
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