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Grading in cancer is distinguished from staging, which is a measure of the extent to which the cancer has spread. Pathology grading systems classify the microscopic cell appearance abnormality and deviations in their rate of growth with the goal of predicting developments at tissue level (see also the 4 major histological changes in dysplasia).
G (1–4): the grade of the cancer cells (i.e. they are "low grade" if they appear similar to normal cells, and "high grade" if they appear poorly differentiated) S (0–3): elevation of serum tumor markers; R (0–2): the completeness of the operation (resection-boundaries free of cancer cells or not) Pn (0–1): invasion into adjunct nerves
For premalignant dysplastic changes, the CIN (cervical intraepithelial neoplasia) grading system is used. [7] Colon cancer: originally consisted of four stages: A, B, C, and D (the Dukes staging system). More recently, colon cancer staging is indicated either by the original A-D stages or by TNM. [8] Kidney cancer: uses TNM. [9]
There are several reasons why PIN is the most likely prostate cancer precursor. [3] PIN is more common in men with prostate cancer. High grade PIN can be found in 85 to 100% of radical prostatectomy specimens, [4] nearby or even in connection with prostate cancer. It tends to occur in the peripheral zone of the prostate.
For example, if the primary tumor grade was 2 and the secondary tumor grade was 3 but some cells were found to be grade 4, the Gleason score would be 2+4=6. This is a slight change from the pre-2005 Gleason system where the second number was the secondary grade (i.e., the grade of the second-most common cell line pattern).
Progression to cancer typically takes 15 years with a range of 3 to 40 years. Also, evidence suggests that cancer can occur without first detectably progressing through CIN grades and that a high-grade intraepithelial neoplasia can occur without first existing as a lower grade. [1] [29] [33]
The concept of grading of the tumors of the central nervous system, agreeing for such the regulation of the "progressiveness" of these neoplasias (from benign and localized tumors to malignant and infiltrating tumors), dates back to 1926 and was introduced by P. Bailey and H. Cushing, [1] in the elaboration of what turned out the first systematic classification of gliomas.
The 1973 WHO grading system for transitional cell carcinomas (papilloma, G1, G2 or G3) is most commonly used despite being superseded by the 2004 WHO [14] grading for papillary types (papillary neoplasm of low malignant potential [PNLMP], low grade, and high grade papillary carcinoma). High-grade carcinoma typically displays more pleomorphism ...